In this policy brief, we estimate and document rural hospital charges due to ambulatory care sensitive conditions (ACSCs) in the United States, by insurance type, from 2000 to 2004. ACSCs are specific adverse health conditions that can be managed in an ambulatory setting and should not require hospitalization. Hospital charges due to ACSCs are reported by region and payment source (private insurance, Medicare, Medicaid, uninsured). Community hospitals are important safety-net providers, and ACSC-related hospital expenditures in those hospitals could reflect the consequences of uninsurance and underinsurance (inhibiting access to ambulatory services). Research about the trends of ACSC-related hospitalizations can contribute to the assessment of the access to and quality of primary health care systems across US regions over time. Our study used nationwide hospital inpatient discharge data to examine the trends and regional variations of rural hospital charges due to ACSCs.
[Show abstract][Hide abstract] ABSTRACT: Background: The need for nursing leaders in rural health care is critical as the nursing workforce adjusts to: severe shortages, growing health disparities, increasing globalization, widespread need for disaster preparedness, and continued shrinking of the healthcare budget. This presentation reports on an advanced nursing education grant preparing leaders in public health nursing, health systems management, and psychiatric mental health nursing with expertise in rural health care to address preventable health problems, improve functioning for those with chronic illness, and to meet the needs of disadvantaged rural populations. Description: Transformational leaders have a clear vision and exert influence as role models who are willing to take risks and are responsive to the needs of the community. Our model for transformational leadership was expanded to address rural healthcare systems in the context of rural population and community characteristics. By recruiting students who are practicing in rural areas and by delivering essential curriculum components electronically, the program promotes education and retention of healthcare resources in rural places. Lessons Learned: It is important to infuse MSN and DNP curriculum with transformational leadership principles, strengthen existing distance-based education modalities, and emphasize rural healthcare concepts. MSN and DNP graduates empowered with transformational skills are prepared to assume leadership in rural communities and to become change agents, influencing the nursing workforce, other disciplines, and communities. Recommendations: Our goal is consistent with the recent report on the future of nursing, which addresses the compelling need for well-trained nursing leaders who practice at the highest level of their education.
139st APHA Annual Meeting and Exposition 2011; 11/2011
[Show abstract][Hide abstract] ABSTRACT: Rural health disparities are due in part to access barriers to healthcare providers. Nursing education has been extended into rural areas, yet a limited rural research and practice literature informs the content and delivery of these educational programs. The University Of Virginia School of Nursing (UVASON) through a grant from the Health Resources and Services Administration developed the Nursing Leadership in Rural Health Care Program (NLRHC). The Transformational Nursing Leadership in Rural Health Care (TNLRHC) model guided the development of NLRHC program content and teaching methods. This paper describes the TNLRHC model and how it has steered the integration of rural content into advanced practice nursing (APN) education. The capacity of the TNLRHC model for promoting innovation in APN education is described. Recommendations regarding the future development of APN education are presented.
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