Background: Reductions in primary care and specialist physicians follow rural hospital closures. As the supply of physicians declines, rural healthcare systems increasingly rely on nurse practitioners (NPs) and certified registered nurse anesthetists (CRNAs) to deliver care.
Purpose: We sought to examine the extent to which rural hospital closures are associated with changes in the NP and CRNA workforce.
Method: Using Area Health Resources Files (AHRF) data from 2010-2017, we used an event-study design to estimate the relationship between rural hospital closures and changes in the supply of NPs and CRNAs.
Findings: Among 1,544 rural counties, we observed 151 hospital closures. After controlling for local market characteristics, we did not find a significant relationship between hospital closure and the supply of NPs and CRNAs.
Discussion: We do not find evidence that NPs and CRNAs respond to rural hospital closures by leaving the healthcare market.
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http://dx.doi.org/10.1016/j.outlook.2021.05.005 | DOI Listing |
Childs Nerv Syst
January 2025
Division of Neurosurgery, Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Purpose: We sought to evaluate the incidence, natural history, and management of cystic spinal lesions following myelomeningocele/myeloschisis closure.
Methods: We performed a single-center retrospective review of all patients who underwent myelomeningocele/myeloschisis closure from 2013 to 2018 with follow-up to 5 years old.
Results: We analyzed 100 fetal repairs and 81 postnatal closures from 305 total surgeries.
J Cell Biol
February 2025
Autophagy, Inflammation and Metabolism Center of Biomedical Research Excellence, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Canonical autophagy captures within specialized double-membrane organelles, termed autophagosomes, an array of cytoplasmic components destined for lysosomal degradation. An autophagosome is completed when the growing phagophore undergoes ESCRT-dependent membrane closure, a prerequisite for its subsequent fusion with endolysosomal organelles and degradation of the sequestered cargo. ATG9A, a key integral membrane protein of the autophagy pathway, is best known for its role in the formation and expansion of phagophores.
View Article and Find Full Text PDFHealth Serv Res
December 2024
Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, New York, USA.
Objective: To determine whether rural hospital closures affected hospital and post-acute care (PAC) use and outcomes.
Study Setting And Design: Using a staggered difference-in-differences design, we evaluated associations between 32 rural hospital closures and changes in county-level: (1) travel distances to and lengths of stay at hospitals; (2) functional limitations at and time from hospital discharge to start of PAC episode; (3) 30-day readmissions and mortality and hospitalizations for a fall-related injury; and (4) population-level hospitalization and death rates.
Data Sources And Analytic Sample: 100% Medicare claims and home health and skilled nursing facility clinical data to identify approximately 3 million discharges for older fee-for-service Medicare beneficiaries.
Cureus
November 2024
Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University) Pune, Pune, IND.
Urethrovaginal fistulas are rare complications often arising from urethrovaginal injuries commonly due to obstetrical trauma, urethral surgeries, pelvic fractures, or neoplastic treatments. Here, we present a unique case involving a 23-year-old female patient with a large urethrovaginal fistula and complete anterior vaginal wall sloughing following prolonged obstructed labor. Nine months post-cesarean, she reported urine leakage via the vagina upon catheter removal, which intensified in an erect posture.
View Article and Find Full Text PDFPhotodiagnosis Photodyn Ther
December 2024
Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China, Ministry of Education International Joint Laboratory of Ocular Diseases, Tianjin, China, Tianjin Key Laboratory of Ocular Trauma, Tianjin, China, Tianjin Institute of Eye Health and Eye Diseases, Tianjin, China, China-UK "Belt and Road" Ophthalmology. Electronic address:
Background: This study investigated the association between photoreceptor structural restoration and visual function outcomes in patients undergoing surgery for closed macular holes (MHs). Using adaptive optics scanning laser ophthalmoscopy (AOSLO) and microperimetry, we aimed to provide a more detailed understanding of photoreceptor recovery and visual improvement in closed MHs.
Methods: We conducted a retrospective observational study of 31 eyes of 28 patients who underwent vitrectomy with internal limiting membrane (ILM) peeling to treat idiopathic MHs.
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