Early adoption of telehealth/remote patient monitoring and hospital revenue changes during COVID-19.

Introduction: The COVID-19 pandemic dramatically affected the financial performance of hospitals across the U.S. The prompt availability of telehealth options likely impacted both a hospital's healthcare options and opportunities for revenue in the short-term.

Rural Hospital Service Lines: Changes Over Time and Impacts on Profitability.

Goal: To document shifts in rural hospital service line offerings between 2010 and 2021 and to assess the resulting impacts on hospital profitability.

Methods: We used annual Medicare cost report data for all rural hospitals that did not change payment classifications between 2010 and 2021. We documented changes in the percentages of hospitals offering each of the 37 inpatient or ancillary service lines included in the data.

Community sociodemographics and rural hospital survival.

Purpose: To determine whether community sociodemographic factors are associated with the survival or closure of rural hospitals at risk of financial distress between 2010 and 2019.

Methods: We use a national sample of 985 rural hospitals at risk of financial distress to analyze the relationship between community sociodemographic characteristics and hospital survival or closure. We control for financial distress using the Financial Distress Index developed by the Sheps Center for Health Services Research.

Gauging Local Interest in Telemedicine Visits: Are Online Surveys Enough?

Telemedicine use surged during COVID-19, and a significant amount of recent research has relied solely on online surveys to assess patient perceptions. However, these surveys may be biased since they require an internet connection and digital literacy skills. We compare local perceptions of telemedicine visits in rural areas across two methods of data collection: online-only vs.

Higher Electronic Health Record Functionality Is Associated with Lower Operating Costs in Urban-but Not Rural-Hospitals.

Objectives: The aim of the study is to examine the relationship between electronic health record (EHR) use/functionality and hospital operating costs (divided into five subcategories), and to compare the results across rural and urban facilities.

Methods: We match hospital-level data on EHR use/functionality with operating costs and facility characteristics to perform linear regressions with hospital- and time-fixed effects on a panel of 1,596 U.S.

Community Meetings on the Rural Opioid Crisis: Setting a Path Forward by Learning from Others.

Objectives: This study implemented a series of meetings in one rural community struggling with the opioid crisis. Set in the town of Ardmore, Oklahoma, these meetings presented local residents who dealt with the crisis as part of their jobs with four categories of programs aimed at preventing and treating opioid-related issues. The ultimate goal was for the participants to develop a consensus about where resources should be appropriated in the future, based off the needs of the area.

State broadband policy: Impacts on availability.

We use a county-level panel dataset from 2012 to 2018 to assess the impacts of various state policies on total and rural broadband availability in the United States. The primary dependent variable is the percentage of residents with access to 25 Megabits per second (MBPS) download and 3 MBPS upload speeds via a fixed connection, with alternative specifications considering other aspects of availability such as technology type and competition. We control for the main determinants of Internet availability such as income, education, age, and population density.

Are Rural Opioid Treatment Program (OTP) Facilities Associated with Lower Deaths?

: Rural areas have been particularly affected by the opioid epidemic in the U.S., with treatment options being scarce.

Do prescription drug monitoring programs encourage prescription - or illicit - opioid abuse?

Prescription drug monitoring programs (PDMPs) are tools that states can use to fight prescription opioid misuse within their jurisdiction. However, because PDMPs make prescription opioids more difficult to access, these programs may have the unintended consequence of increasing deaths related to illicit opioids. : This study uses fixed effects models to estimate how PDMP regulatory strength is associated with both prescription opioid- and heroin-related deaths between 1999 and 2016.

The Influence of the Degree of Rurality on EMR Adoption, by Physician Specialty.

Objective: To explore the influence of varying degrees of remoteness on practice-level electronic medical record (EMR) adoption, including whether the effect differs across practice specialty.

Data Sources: Survey data on over 270,000 office-based physician practices (representing over 1,250,000 providers) collected by SK&A information services during 2012.

Study Design: This study examined differences in EMR adoption by practices located across the nine-category rural-urban continuum.

What Can the National Broadband Map Tell Us About the Health Care Connectivity Gap?

Purpose: Internet connection speeds are generally slower in rural areas, and this issue is rising in importance for health care facilities as technologies such as Electronic Health Records and Health Information Exchanges become more common. However, the extent of the rural-urban divide in terms of health care connectivity has not been fully quantified. This report uses data compiled from the National Broadband Map (NBM) to compare levels of health care facility connectivity across metropolitan and nonmetropolitan counties.

Rural EMR adoption rates overtake those in urban areas.

Objective: To assess rural-urban differences in electronic medical record (EMR) adoption among office-based physician practices in the United States.

Methods: Survey data on over 270 000 office-based physician sites (representing over 1 280 000 physicians) in the United States from 2012 was used to assess differences in EMR adoption rates among practices in rural and urban areas. Logistic regression tests for differences in the determinants of EMR adoption by geography, and a nonlinear decomposition is used to quantify how much of the rural-urban gap is due to differences in measureable characteristics (such as type of practice or affiliation with a health system).

Electronic medical record adoption in Oklahoma practices: rural-urban differences and the role of broadband availability.

Purpose: Most recent research has not found significant differences in electronic medical record (EMR) adoption rates between rural and urban physicians. However, few studies have assessed rural/urban differences at a lower level--for instance, by specialty or size of practice. Determinants of EMR adoption by physician practices in Oklahoma are explored, including the potential role of broadband availability (which is required for EMR interoperability).

Critical access hospitals and retail activity: an empirical analysis in Oklahoma.

Purpose: This paper takes an empirical approach to determining the effect that a critical access hospital (CAH) has on local retail activity. Previous research on the relationship between hospitals and economic development has primarily focused on single-case, multiplier-oriented analysis. However, as the efficacy of federal and state-level rural health subsidies come under increasing scrutiny, more comprehensive investigations can provide support for continued funding.

Interest in rural medicine among osteopathic residents and medical students.

Introduction: This study examines US osteopathic residents' and medical students' attitudes and willingness to practice in rural medicine. The multiple aims of this study were to determine: (1) if there are any significant differences in interest in rural medicine among various levels of training; (2) the relative age, gender, and race of those who are intending to pursue a career in rural health; and (3) whether a number of demographic characteristics (age, race, year of study) or participation in a rural elective significantly impacted the students' and residents' interest in practicing in a rural area. In particular, differences between osteopathic students and residents are emphasized, because few previous studies have focused on this topic.