Rural Health
Research Gateway

Quality

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2024

2023

2022

  • Rural-Urban Disparities in Quality of Inpatient Psychiatric Care
    Journal Article
    Rural and Minority Health Research Center
    Date: 11/2022
    Using data from the Inpatient Psychiatric Facility Quality Reporting program 2015-2019, this study examined differences and changes in the quality of inpatient psychiatric care in rural and urban hospitals.
  • Prehospital Emergency Medical Services Personnel: Comparing Rural and Urban Professional Experience and Provision of Evidence-Based Care
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 05/2022
    This policy brief examines the effects of emergency medical services (EMS) personnel level of experience and agency rurality on the provision of evidenced-based care. Compared with urban-serving EMS agencies, rural-serving agencies provided evidence-based care less often for stroke, hypoglycemia, and trauma but more often for seizures.
  • Quality of Home Health Agencies Serving Rural Medicare Beneficiaries
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 02/2022
    This policy brief describes the quality of home health agencies (HHAs) by rural-serving status. While quality of patient care star ratings were not associated with rural-serving status, rural HHAs and urban HHAs that serve rural patients had higher patient experience star ratings than urban HHAs that do not serve rural patients.
  • Quality of Skilled Nursing Facilities Serving Rural Medicare Beneficiaries
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 02/2022
    This policy brief describes the quality of skilled nursing facilities (SNFs) by rural-serving status. While overall star ratings and staffing star ratings were not associated with rural-serving status, rural SNFs and urban SNFs that serve rural patients had lower quality star ratings compared to urban SNFs that do not serve rural patients.

2021

2020

2019

  • Quality Measures for Critical Access Hospital Swing Bed Patients
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2019
    This study identified measures to be used to assess the quality of care provided to Critical Access Hospital (CAH) swing bed patients with the goal of having these measures endorsed by the National Quality Forum and used by policymakers to help assess the value of CAH swing beds.
  • Primary Care Clinician Participation in the CMS Quality Payment
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2019
    Approximately 10% of primary care clinicians participate in Advanced Alternative Payment Models (A-APMs) and less than 30% of primary care clinicians participate in the Merit-Based Incentive Payment System. Metropolitan primary care clinicians are more likely to participate in A-APMs than nonmetropolitan primary care clinicians.

2018

2017

2016

  • Medicare Accountable Care Organizations: Quality Performance by Geographic Categories
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2016
    Provides an analysis of the differences in Accountable Care Organization (ACO) performance on the quality measures among the Medicare Shared Saving Program ACOs with varying levels of rural presence. Findings suggest that ACOs with significant rural presence have performed as well as, if not better than, urban ACOs in delivering quality care.
  • Rural Medicare Advantage Market Dynamics and Quality: Historical Context and Current Implications
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 07/2016
    There is significant variation in the quality ratings of MA plans that are available to rural beneficiaries. This brief suggests that policy interventions may be necessary to improve the quality of MA plans in rural areas.
  • Ensuring Access to High-Quality Maternity Care in Rural America
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    Examines the access to high-quality for rural women care during pregnancy and childbirth. Policy interventions at the local, state, and federal levels could help to address maternity care workforce shortages and improve quality of care available to the one-half million rural U.S. women who give birth each year.
  • Quality Measures and Sociodemographic Risk Factors: The Rural Context
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    This policy brief aims to inform discussions concerning whether or not to adjust provider quality measures for differences in patient characteristics by examining how rurality and key sociodemographic variables might affect quality-of-care outcomes.
  • Rural Implications of Expanded Birth Volume Threshold for Reporting Perinatal Care Measures
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 04/2016
    In 2016 the minimum annual birth volume threshold for required reporting of the Joint Commission Perinatal Care measures by accredited hospitals decreased from 1,100 to 300 births. This study used the publicly available Join Commission Quality Check data from April 2014 to March 2015.
  • Pilot Testing a Rural Health Clinic Quality Measurement Reporting System
    Policy Brief
    Maine Rural Health Research Center
    Date: 02/2016
    More than 4,000 Rural Health Clinics (RHCs) serve the primary care needs of rural communities. Unfortunately, the Rural Health Clinic Program is plagued by a lack of data participating clinics. This reports on the results with a focus on assessing the feasibility and utility of the reporting system and quality measures for the participating RHCs.
  • Surgical Patient Safety Outcomes in Critical Access Hospitals: How Do They Compare?
    Journal Article
    RUPRI Center for Rural Health Policy Analysis
    Date: 02/2016
    Examines how Critical Access Hospitals perform compared to Prospective Payment System hospitals on measures of quality.

2015

2014

2012

2011

  • Will Bundling Work in Rural America? Analysis of the Feasibility and Consequences of Bundled Payments for Rural Health Providers and Patients
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 09/2011
    This report assesses the challenges and consequences for rural providers and patients of implementing bundled payments for acute and post-acute care episodes; explores impacts on care quality under a facility-physician bundled payment system; and describes potential modifications to bundling proposals and steps that could address rural issues.
  • Care Transitions: "Time to Come Home"
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 03/2011
    This policy brief examines care coordination, with a focus on the transitions from inpatient care back to the rural community, and suggests ways of measuring the quality of care coordination on discharge from the hospital.
  • Care Transitions: "Time to Come Home" (Full Report)
    Upper Midwest Rural Health Research Center
    Date: 03/2011
    This report looks at care coordination for rural patients, with a focus on transitions from inpatient care back to the rural community, and suggests ways of measuring the quality of care coordination on discharge from the hospital.

2010

2009

  • Implementing Patient Safety Initiatives in Rural Hospitals
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 09/2009
    This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for patient safety initiatives in eight small Tennessee rural hospitals using a multi-organizational collaborative model. The demonstration identified and facilitated implementation of three patient safety interventions.
  • Achieving Success in QIO and Rural Hospital Partnerships (Final Report)
    NORC Walsh Center for Rural Health Analysis
    Date: 02/2009
    This report describes four case studies that highlight the strategies employed by Quality Improvement Organizations (QIOs) to help small rural hospitals implement successful quality-improvement initiatives.

2008

2007

2006

2005

2004

  • Critical Access Hospital Patient Safety Priorities and Initiatives: Results of the 2004 National CAH Survey
    University of Minnesota Rural Health Research Center
    Date: 09/2004
    This paper describes the patient safety results from a 2004 survey of critical access hospital administrators.
  • Quality Improvement Activities in Critical Access Hospitals: Results of the 2004 National CAH Survey
    University of Minnesota Rural Health Research Center
    Date: 09/2004
    This paper describes quality improvement efforts in critical access hospitals (CAHs) based on a 2004 survey of 474 CAH administrators. It includes data on the use of clinical guidelines and quality measures in CAHs and the role of Medicare Quality Improvement Organizations.
  • Access To Primary Care and Quality of Care in Rural America
    NORC Walsh Center for Rural Health Analysis
    Date: 06/2004
    This report provides findings from a population-based study addressing the impact of the availability of healthcare resources on the rate of potentially avoidable hospitalizations. It suggests shortcomings with previous research conducted in communities that experienced problems accessing primary care services.
  • Nursing Homes in Rural And Urban Areas, 2001
    Southwest Rural Health Research Center
    Date: 06/2004
    This chartbook provides descriptive data on the entire population of longer-stay nursing home residents in the country in 2001 and categorizes them according to the rurality of the nursing homes in which they receive care in an effort to address questions related to residents' characteristics and quality of care.are.
  • Measuring Rural Hospital Quality
    University of Minnesota Rural Health Research Center
    Date: 04/2004
    This paper seeks to identify rural hospital quality measures that reflect quality in all hospitals and are sensitive to the rural hospital context.
  • Rural Health Research in Progress in the Rural Health Research Centers Program, 8th Edition
    Maine Rural Health Research Center
    Date: 02/2004
    This book provides policy makers with a concise source of rural health services research underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. It provides a context for legislation current and proposed that affects rural health services and populations.
  • Quality Improvement Strategies and Best Practices in Critical Access Hospitals
    University of Minnesota Rural Health Research Center
    Date: 01/2004
    This paper describes critical access hospital (CAH) quality improvement (QI) initiatives, with examples of best practices from two CAHs that have innovative QI programs. It includes lists of changes made to staffing, training, equipment, and other issues related to QI.
  • Comparative Performance Data for Critical Access Hospitals
    Journal Article
    Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center
    Date: 2004
    Discusses the potential use of comparative performance data for critical access hospitals (CPD-CAH) to facilitate performance and quality improvement. Covers potential benefits and drawbacks of CPD-CH and identifies issues in the development and implementation of CPD-CAH.
  • Quality of Care for Acute Myocardial Infarction in Rural and Urban U.S. Hospitals
    Journal Article
    WWAMI Rural Health Research Center
    Date: 2004
    Acute myocardial infarction (AMI) is a common and important cause of admission to rural hospitals, as transport of patients with AMI to urban settings can result in unacceptable delays in care. This study examines the quality of care for patients with AMI in rural hospitals with differing degrees of remoteness from urban centers.

2003

  • Environmental Context of Patient Safety and Medical Errors
    University of Minnesota Rural Health Research Center
    Date: 03/2003
    This paper explores the environmental context of patient safety/medical errors with specific interest in rural areas. It reviews patient safety/medical error literature, identifies features of rural healthcare organizations and their environment relating to patient safety issues/medical errors, and discusses error reduction/prevention strategies.
  • 2003 Index of Hospital Quality
    NORC Walsh Center for Rural Health Analysis
    Date: 2003
    Published annually by U.S. News & World Report, this report describes a series of factors regarding ranking of measuring hospital quality.

2002

2001