An updated model of rural hospital financial distress.

Purpose: To create a model that predicts future financial distress among rural hospitals.

Methods: The sample included 14,116 yearly observations of 2311 rural hospitals recorded between 2013 and 2019. We randomly separated all sampled hospitals into a training set and test set at the start of our analysis.

Enhanced Primary Care for People With Serious Mental Illness: A Propensity Weighted Cohort Study.

People with serious mental illness (SMI) have high rates of cardiometabolic illness, receive low quality care, and experience poor outcomes. Nevertheless, studies of existing integrated care models have not consistently shown improvements in cardiometabolic health for people with SMI. This study assessed the effect of a novel model of enhanced primary care for people with SMI on cardiometabolic outcomes.

Predictors of hospital bypass for rural residents seeking common elective surgery.

Background: Surgical bypass occurs when rural residents receive surgical care at a nonlocal hospital. Given limited knowledge of current bypass rates, we evaluated rates and predictors of bypass for common procedures.

Methods: We used 2014 to 2016 all-payer claims data from the Healthcare Cost and Utilization Project State Inpatient Databases to study rural patients from 13 states who underwent 1 of 11 common elective surgical procedures.

The economic effects of rural hospital closures.

Objective: To provide an updated analysis of the economic effects of rural hospital closures.

Study Setting: Our study sample was national in scope and consisted of nonmetro counties from 2001 to 2018.

Study Design: We used a difference-in-differences study design to estimate the effect of a hospital closure on county income, population, unemployment, and size of the labor force.

Effect of Enhanced Primary Care for People with Serious Mental Illness on Service Use and Screening.

Background: Strategies are needed to better address the physical health needs of people with serious mental illness (SMI). Enhanced primary care for people with SMI has the potential to improve care of people with SMI, but evidence is lacking.

Objective: To examine the effect of a novel enhanced primary care model for people with SMI on service use and screening.

Decline in Inpatient Volume at Rural Hospitals.

Purpose: To investigate (1) all-payer inpatient volume changes at rural hospitals and (2) whether trends in inpatient volume differ by organizational and geographic characteristics of the hospital and characteristics of the patient population.

Methods: We used a retrospective, longitudinal study design. Our study sample consisted of rural hospitals between 2011 and 2017.

Efficient detection of unpaired DNA requires a member of the rad54-like family of homologous recombination proteins.

Meiotic silencing by unpaired DNA (MSUD) is a process that detects unpaired regions between homologous chromosomes and silences them for the duration of sexual development. While the phenomenon of MSUD is well recognized, the process that detects unpaired DNA is poorly understood. In this report, we provide two lines of evidence linking unpaired DNA detection to a physical search for DNA homology.