Adverse Childhood Experiences, Health-Related Quality of Life, and Chronic Disease Risks in Rural Areas of the United States.

Exposure to adverse childhood experiences (ACEs) is associated with increased odds of high-risk behaviors and adverse health outcomes. This study examined whether ACE exposure among individuals living in rural areas of the United States is associated with adult activity limitations, self-reported general poor health status, chronic diseases, and poor mental health. Data from the 2011 and 2012 Behavioral Risk Factor Surveillance System (BRFSS) (N=79,810) from nine states were used to calculate the prevalence of ACEs in rural and urban areas.

Rural implications of Medicare's post-acute-care transfer payment policy.

Context: Under the Medicare post-acute-care (PAC) transfer policy, acute-care hospitals are reimbursed under a per-diem formula whenever beneficiaries are discharged from selected diagnosis-related groups (DRGs) to a skilled nursing facility, home health care, or a prospective payment system (PPS)-excluded facility. Total per-diem payments are below the full DRG payment only when the patient's length of stay (LOS) is short relative to the geometric mean LOS for the DRG; otherwise, the full DRG payment is received. This policy originally applied to 10 DRGs beginning in fiscal year 1999 and was expanded to additional DRGs in FY2004.

Perspectives of rural hospitals on bioterrorism preparedness planning.

Even the smallest, most isolated rural hospitals are now required to have bioterrorism preparedness plans. From the perspective of many rural hospitals, however, there is a disparity between Federal expectations and the realities of small hospitals operating in geographically isolated communities. As part of an effort to better understand how to close this gap, the Walsh Center for Rural Health Analysis convened a panel of representatives of rural hospitals who are responsible for bioterrorism preparedness in their hospitals.