Health services research
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Health services research · Apr 2020
Relationship between initiation of 340B participation and hospital safety-net engagement.
The 340B program allows safety-net hospitals to acquire discounted outpatient drugs and charge payers full price. We examined whether 340B participation increases safety-net engagement. ⋯ Alternative measures show that newly participating hospitals may increase charity care, potentially through offering more patients discounted care. However, increases appear to be fully offset by reductions in other community benefit programs.
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Health services research · Apr 2020
The effect of rural hospital closures on emergency medical service response and transport times.
To examine the effect of rural hospital closures on EMS response time (minutes between dispatch notifying unit and arriving at scene); transport time (minutes between unit leaving the scene and arriving at destination); and total activation time (minutes between 9-1-1 call to responding unit returning to service), as longer EMS times are associated with worse patient outcomes. ⋯ Rural hospital closures increased mean transport and total activation times with varying effects across the distribution of EMS response, transport, and total times. These findings illuminate potential barriers to accessing timely emergency services due to closures.
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Health services research · Apr 2020
The association of hospital teaching intensity with 30-day postdischarge heart failure readmission and mortality rates.
To investigate risk-adjusted, 30-day postdischarge heart failure mortality and readmission rates stratified by hospital teaching intensity. ⋯ Heart failure readmission penalties disproportionately impact major teaching hospitals and inadequately credit their better postdischarge survival.