Decline in Inpatient Volume at Rural Hospitals
© 2020 National Rural Health Association..
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. Inpatient volume was measured as inpatient average daily census (ADC). Additional measured hospital characteristics included census region, Medicare payment type, ownership type, number of beds, local competition, total margin, and whether the hospital was located in a Medicaid expansion state. Measured characteristics of the local patient population included total population size, percent of population aged 65 years or older, and percent of population in poverty. To identify predictors of inpatient volume trends, we fit a linear multiple regression model using generalized estimating equations.
FINDINGS: Rural hospitals experienced an average change in ADC of -13% between 2011 and 2017. We found that hospital characteristics (eg, census region, Medicare payment type, ownership type, total margin, whether the hospital was located in a Medicaid expansion state) and patient population characteristics (eg, percent of population in poverty) were significant predictors of inpatient volume trends.
CONCLUSIONS: Trends in inpatient volume differ by organizational and geographic characteristics of the hospital and characteristics of the patient population. Researchers and policy makers should continue to explore the causal mechanisms of inpatient volume decline and its role in the financial viability of rural hospitals.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association - 37(2021), 2 vom: 31. März, Seite 347-352 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Malone, Tyler L [VerfasserIn] |
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| Links: |
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| Themen: |
Inpatient volume |
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| Anmerkungen: |
Date Completed 18.08.2021 Date Revised 18.08.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/jrh.12553 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319465586 |
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| 500 | |a Date Completed 18.08.2021 | ||
| 500 | |a Date Revised 18.08.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 National Rural Health Association. | ||
| 520 | |a 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 | ||
| 520 | |a METHODS: We used a retrospective, longitudinal study design. Our study sample consisted of rural hospitals between 2011 and 2017. Inpatient volume was measured as inpatient average daily census (ADC). Additional measured hospital characteristics included census region, Medicare payment type, ownership type, number of beds, local competition, total margin, and whether the hospital was located in a Medicaid expansion state. Measured characteristics of the local patient population included total population size, percent of population aged 65 years or older, and percent of population in poverty. To identify predictors of inpatient volume trends, we fit a linear multiple regression model using generalized estimating equations | ||
| 520 | |a FINDINGS: Rural hospitals experienced an average change in ADC of -13% between 2011 and 2017. We found that hospital characteristics (eg, census region, Medicare payment type, ownership type, total margin, whether the hospital was located in a Medicaid expansion state) and patient population characteristics (eg, percent of population in poverty) were significant predictors of inpatient volume trends | ||
| 520 | |a CONCLUSIONS: Trends in inpatient volume differ by organizational and geographic characteristics of the hospital and characteristics of the patient population. Researchers and policy makers should continue to explore the causal mechanisms of inpatient volume decline and its role in the financial viability of rural hospitals | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a inpatient volume | |
| 650 | 4 | |a rural health care | |
| 650 | 4 | |a rural hospital | |
| 700 | 1 | |a Pink, George H |e verfasserin |4 aut | |
| 700 | 1 | |a Holmes, George M |e verfasserin |4 aut | |
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