Wednesday Roundup: Rural Hospital Death Rates
Services and survival rates at smaller, more rural hospitals are significantly worse than at other hospitals a Harvard School of Public Health study finds.
The report was published Wednesday in the Journal of the American Medical Association. It found that these critical access hospitals (CHAs), which have no more than 25 beds and are located more than 35 miles from full-service hospitals, had higher death rates than urban hospitals. The study compared treatment for heart attacks, congestive heart failure and pneumonia.
“Critical access hospitals play an important and unique role in the U.S. health care system, caring for individuals who live in rural areas and who might otherwise have no accessible inpatient care,” wrote Dr. Karen E. Joynt, of the Harvard School of Public Health, and colleagues.
“Despite more than a decade of concerted policy efforts to improve rural health care, our findings suggest that substantial challenges remain. Although CAHs provide much-needed access to care for many of the nation’s rural citizens, we found that these hospitals, with their fewer clinical and technological resources, less often provided care consistent with standard quality metrics and generally had worse outcomes than non-CAHs,” the authors concluded.
• The Federal Emergency Management Agency bought thousands of housing trailers and mobile homes after Hurricane Katrina struck. Most were never used. Now many of those trailers are finding their way to Indian reservations, the AP reports.
The Katrina trailers became a symbol of an inept government. The trailers were impractical in areas where water, electricity and sewage systems had been destroyed, the AP reports. And the mobile homes were found to contain high levels of formaldehyde, a cancer-causing chemical common in building materials. Many local officials didn’t want the trailers because they were afraid they would become permanent housing.
Over time, some of the trailers were auctioned. But almost 2,000 have been given to tribes. The FEMA trailers are like “castles,” Cheryle Causley, chair of the National American Indian Housing Council, told the AP.
“It shows you the vast discrepancy and the uneven treatment among the citizens of the United States,” Causley said. “Our people would go miles to receive those units. If there’s any more of them, we would love them. Our need is that extreme.”
• Okay, we’ve had floods and fires. Now we have dust.
Winds out of Arizona swept massive clouds of dust across the state and into Phoenix.
• Wall Street firms are making money not only by trading commodities, but by storing them.
Over the last 18 months, firms such as Goldman Sachs and J.P. Morgan Chase have been snapping up warehouse operators, for metal, grain, whatever. This Wall Street Journal story focuses on metals, but the same firms are making money storing grains.
• Speaking of floods, here’s a good slideshow of high water in Minot, North Dakota. http://www.fcpp.org/blog/?p=1997#more-1997
• Sen. Pat Roberts, ranking member of the Senate ag committee, has scheduled a hearing on the Farm Bill for August 25 in Wichita.
• Minnesota Public Radio reports that the rural health care system is under new pressure:
National health care reform is forcing expensive record-keeping changes. Greater reliance on Medicare and Medicaid reimbursement makes rural providers vulnerable. Rural people tend to be older and poorer, are less likely to have insurance and suffer more chronic illness. And the doctor shortage has gotten harder to deal with.
In response, care is changing. Services like mental health counseling are delivered via teleconference. Clinics and hospitals are consolidating. “Midlevel” practitioners like paramedics and dental therapists are starting to play new roles.
• The New York Times reports that states are saving money by cutting the school day and the school year. Instead of increasing time in the classroom, it is being reduced.
The Times reports: “A scattering of rural districts in New Mexico, Idaho and other states will be closed on Fridays or Mondays come September.”