41 results match your criteria cahs inpatient


An Observational Study of Telemental Care Delivery and the Context for Involuntary Commitment for Mental Health Patients in a Group of Rural Emergency Departments.

Telemed Rep 2020 18;1(1):22-35. Epub 2020 Nov 18.

Department of Research, Richard Lugar Center for Rural Health, Union Hospital, Terre Haute, Indiana, USA.

Rates for all-cause U.S. emergency department (ED) visits to rural critical access hospitals (CAHs) have increased by 50% since 2005. Read More

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November 2020

What Is the Quality of Surgical Care for Patients with Hip Fractures at Critical Access Hospitals?

Clin Orthop Relat Res 2021 01;479(1):9-16

J. M. Bonsu, M. Roser, L. S. Phieffer, T. V. Ly, R. K. Harrison, C. E. Quatman, Division of Orthopaedic Trauma, Department of Orthopaedics, the Ohio State University Wexner Medical Center, Columbus, OH, USA.

Background: Critical access hospitals (CAHs) play an important role in providing access to care for many patients in rural communities. Prior studies have shown that these facilities are able to provide timely and quality care for patients who undergo various elective and emergency general surgical procedures. However, little is known about the quality and reimbursement of surgical care for patients undergoing surgery for hip fractures at CAHs compared with non-CAH facilities. Read More

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January 2021

Use of professional interpreters for children and families with limited English proficiency: The intersection with quality and safety.

J Paediatr Child Health 2020 Aug 7;56(8):1201-1209. Epub 2020 Apr 7.

Refugee Health Service, Department of General Paediatrics, Perth Children's Hospital (PCH), Child and Adolescent Health Service (CAHS), Perth, Western Australia, Australia.

Aim: Linguistic diversity is increasing nationally; patients with limited English proficiency require provision of professional interpreters. We reviewed hospital-wide use of interpreters for low English proficiency in a tertiary hospital across emergency (ED), outpatient and inpatient presentations.

Methods: Two cohorts with low English proficiency presenting to Princess Margaret Hospital were audited. Read More

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The Association Between Telemedicine and Emergency Department (ED) Disposition: A Stepped Wedge Design of an ED-Based Telemedicine Program in Critical Access Hospitals.

J Rural Health 2020 06 23;36(3):360-370. Epub 2019 Apr 23.

Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa.

Purpose: To study the relationship between the availability and activation of emergency department-based telemedicine (teleED) and patient disposition in Critical Access Hospitals (CAHs).

Methods: A non randomized stepped wedge design examined 133,396 ED visits in 15 CAHs that subscribe to a single teleED provider. Data were available for at least 12 months prior to teleED implementation and at least 12 months of post-implementation. Read More

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The Virtual Hospitalist: A Single-Site Implementation Bringing Hospitalist Coverage to Critical Access Hospitals.

J Hosp Med 2018 11 26;13(11):759-763. Epub 2018 Sep 26.

University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.

Background: On-site hospitalist care can improve patient care, but it is economically infeasible for small critical access hospitals (CAHs). A telemedicine "virtual hospitalist" may expand CAH capabilities at a fractional cost of an on"site provider.

Objective: To evaluate the impact of a virtual hospitalist on transfers from a CAH to outside hospitals. Read More

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November 2018

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2019 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs (Promoting Interoperability Programs) Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Medicare Cost Reporting Requirements; and Physician Certification and Recertification of Claims. Final rule.

Authors:

Fed Regist 2018 Aug;83(160):41144-784

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2019. Some of these changes implement certain statutory provisions contained in the 21st Century Cures Act and the Bipartisan Budget Act of 2018, and other legislation. We also are making changes relating to Medicare graduate medical education (GME) affiliation agreements for new urban teaching hospitals. Read More

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Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Program Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Provider-Based Status of Indian Health Service and Tribal Facilities and Organizations; Costs Reporting and Provider Requirements; Agreement Termination Notices. Final rule.

Authors:

Fed Regist 2017 Aug;82(155):37990-8589

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. Read More

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Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates; Quality Reporting Requirements for Specific Providers; Graduate Medical Education; Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services; Technical Changes Relating to Costs to Organizations and Medicare Cost Reports; Finalization of Interim Final Rules With Comment Period on LTCH PPS Payments for Severe Wounds, Modifications of Limitations on Redesignation by the Medicare Geographic Classification Review Board, and Extensions of Payments to MDHs and Low-Volume Hospitals. Final rule.

Authors:

Fed Regist 2016 Aug;81(162):56761-7345

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2017. Some of these changes will implement certain statutory provisions contained in the Pathway for Sustainable Growth Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Notice of Observation Treatment and Implications for Care Eligibility Act of 2015, and other legislation. We also are providing the estimated market basket update to apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2017. Read More

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Implementing a Hospitalist Program in a Critical Access Hospital.

J Rural Health 2018 Dec 6;34(1):109-115. Epub 2016 Jul 6.

Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota.

Purpose: The hospitalist model of inpatient care has rapidly expanded, but little is known about hospitalist care in critical access hospitals (CAHs). We aimed to determine the impact of a hospitalist model of care on staff satisfaction, patient volumes, patient satisfaction, length of stay, and care quality in a CAH.

Methods: We initiated a hybrid rotating hospitalist program in September 2008 at Winneshiek Medical Center (Decorah, Iowa), a 25-bed rural CAH. Read More

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December 2018

Medicare and Medicaid Programs; Fire Safety Requirements for Certain Health Care Facilities. Final rule.

Authors:

Fed Regist 2016 May;81(86):26871-901

This final rule will amend the fire safety standards for Medicare and Medicaid participating hospitals, critical access hospitals (CAHs), long-term care facilities, intermediate care facilities for individuals with intellectual disabilities (ICF-IID), ambulatory surgery centers (ASCs), hospices which provide inpatient services, religious non-medical health care institutions (RNHCIs), and programs of all-inclusive care for the elderly (PACE) facilities. Further, this final rule will adopt the 2012 edition of the Life Safety Code (LSC) and eliminate references in our regulations to all earlier editions of the Life Safety Code. It will also adopt the 2012 edition of the Health Care Facilities Code, with some exceptions. Read More

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Surgical Patient Safety Outcomes in Critical Access Hospitals: How Do They Compare?

J Rural Health 2017 04 16;33(2):117-126. Epub 2016 Feb 16.

Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa.

Purpose: The aim of the study was to examine whether Critical Access Hospitals (CAHs), the predominant type of hospital in small and isolated rural areas, perform better than, the same as, or worse than Prospective Payment System (PPS) hospitals on measures of quality.

Methods: The Healthcare Cost and Utilization Project State Inpatient Databases and American Hospital Association annual survey data were used for analyses. A total of 35,674 discharges from 136 nonfederal general hospitals with fewer than 50 beds were included in the analyses: 14,296 from 100 CAHs and 21,378 from 36 PPS hospitals. Read More

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Rural Bypass for Elective Surgeries.

J Rural Health 2017 04 1;33(2):135-145. Epub 2015 Dec 1.

Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa.

Purpose: Rural bypass of Critical Access Hospitals (CAHs) for elective inpatient and outpatient surgical procedures has not been studied. Residents choosing to have their elective surgeries elsewhere, when the local CAH provides those surgical services, erode their rural hospital's financial base. The purpose of this research is to describe the elective surgical bypass rate, the procedures most commonly bypassed by rural residents, the distribution of volume among CAHs that offer elective surgical services, and factors predictive of bypass. Read More

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The Impact of Hospital Characteristics on the Availability of Radiology Services at Critical Access Hospitals.

J Am Coll Radiol 2015 Dec;12(12 Pt B):1351-6

Harvey L. Neiman Health Policy Institute, Reston, Virginia; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.

Purpose: Although all critical access hospitals (CAHs) provide basic medical and radiographic imaging services, it remains unclear how CAHs provide additional imaging services given relatively low patient volumes and high resource costs. The aim of this study was to examine whether CAHs with more resources or access to resources through affiliation with larger systems are more likely to offer other imaging services in their communities.

Methods: Linking data from the American Hospital Association's annual hospital surveys and the American Hospital Directory's annual surveys from 2009 to 2011, multivariate logistic regressions were performed to estimate the likelihood of individual CAHs with greater financial resources or network affiliations providing specific imaging services (MRI, CT, ultrasound, mammography, and PET/CT), while adjusting for the number of beds, personnel, inpatient revenue share, case mix, rural status, year, and geographic location. Read More

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December 2015

Surgical Services in Critical Access Hospitals, 2011.

Rural Policy Brief 2015 Jan 1(2015 2):1-4. Epub 2015 Jan 1.

In this policy brief we describe the types and volume of major surgical services provided in the inpatient and outpatient settings of Critical Access Hospitals (CAHs) in 2011. Major surgical services are those procedures that require use of an operating room (OR), regardless of whether the procedure was inpatient or outpatient. Key Findings (1) CAH discharges of patients having a major surgical procedure that required use of an OR were analyzed from four regionally representative states: Colorado, North Carolina, Vermont, and Wisconsin. Read More

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January 2015

Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule.

Authors:

Fed Regist 2014 Aug;79(163):49853-50536

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Protecting Access to Medicare Act of 2014, and other legislation. These changes are applicable to discharges occurring on or after October 1, 2014, unless otherwise specified in this final rule. Read More

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Transfer rates and use of post-acute care after surgery at critical access vs non-critical access hospitals.

JAMA Surg 2014 Jul;149(7):671-7

Department of Urology, University of Michigan Health System, Ann Arbor3Center for Healthcare Outcomes and Policy, Institute for Healthcare Policy and Innovation, University of Michigan Health System, Ann Arbor.

Importance: There is growing interest in the use of health care resources by critical access hospitals (CAHs), key providers of medical care for many rural populations.

Objective: To evaluate discharge practice patterns and use of post-acute care after surgical admissions at CAHs.

Design, Setting, And Participants: We used data from the Nationwide Inpatient Sample (2005-2009) and American Hospital Association to perform a retrospective cohort study of patients undergoing common inpatient surgical procedures at CAHs or non-CAHs. Read More

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Hospital, patient, and local health system characteristics associated with the prevalence and duration of observation care.

Health Serv Res 2014 Aug 11;49(4):1088-107. Epub 2014 Mar 11.

Department of Health Management and Policy, University of Iowa College of Public Health, 100 College of Public Health Building N240, Iowa City, IA 52242.

Objective: To examine the association between hospital, patient, and local health system characteristics and the likelihood, prevalence, and duration of observation care among fee-for-service Medicare beneficiaries.

Data Sources: The 100 percent Medicare inpatient and outpatient claims and enrollment files for 2009, supplemented with 2007 American Hospital Association Survey and 2009 Area Resource File data.

Study Design: Using a lagged cross-sectional design, we model the likelihood of a hospital providing any observation care using logistic regression and the conditional prevalence and duration of observation care using linear regression, among 3,692 general hospitals in the United States. Read More

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TRICARE; reimbursement of sole community hospitals and adjustment to reimbursement of critical access hospitals. Final rule.

Authors:

Fed Regist 2013 Aug;78(153):48303-11

This Final Rule implements for Sole Community Hospitals (SCHs) the statutory provision at title 10, United States Code (U.S.C. Read More

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Trends in observation care among Medicare fee-for-service beneficiaries at critical access hospitals, 2007-2009.

J Rural Health 2013 Aug 22;29 Suppl 1:s1-6. Epub 2013 Feb 22.

Center for Gerontology and Health Care Research, Brown University, 121 S. Main St., Providence, RI 02912, USA.

Purpose: Observation care is used to evaluate patients prior to admission or discharge. Often beneficial, such care also imposes greater financial liability on Medicare beneficiaries. While the use of observation care has increased recently, critical access hospitals (CAHs) face different policies than prospective payment (PPS) hospitals, which may influence their observation care use. Read More

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Utilization and outcomes of inpatient surgical care at critical access hospitals in the United States.

JAMA Surg 2013 Jul;148(7):589-96

Department of Urology, University of Michigan Health System, Ann Arbor, MI 48109, USA.

Importance: There is a growing interest in the quality and cost of care provided at Critical Access Hospitals (CAHs), a predominant source of care for many rural populations in the United States.

Objective: To evaluate utilization, outcomes, and costs of inpatient surgery performed at CAHs.

Design, Setting, And Patients: A retrospective cohort study of patients undergoing inpatient surgery from 2005 through 2009 at CAHs or non-CAHs was performed using data from the Nationwide Inpatient Sample and American Hospital Association. Read More

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Rural relevant quality measures for critical access hospitals.

J Rural Health 2013 1;29(2):159-71. Epub 2012 Aug 1.

Rural Health Research Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55414, USA.

Purpose: To identify current and future relevant quality measures for Critical Access Hospitals (CAHs).

Methods: Three criteria (patient volume, internal usefulness for quality improvement, and external usefulness for public reporting and payment reform) were used to analyze quality measures for their relevance for CAHs. A 6-member panel with expertise in rural hospital quality measurement and improvement provided input regarding the final measure selection. Read More

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February 2014

Mortality rates for Medicare beneficiaries admitted to critical access and non-critical access hospitals, 2002-2010.

JAMA 2013 Apr;309(13):1379-87

Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA.

Importance: Critical access hospitals (CAHs) provide inpatient care to Americans living in rural communities. These hospitals are at high risk of falling behind with respect to quality improvement, owing to their limited resources and vulnerable patient populations. How they have fared on patient outcomes during the past decade is unknown. Read More

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Medicare, swing beds, and critical access hospitals.

Med Care Res Rev 2013 Apr 21;70(2):206-17. Epub 2012 Oct 21.

Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7411, USA.

Critical Access Hospitals (CAHs) receive cost-based reimbursement from Medicare for inpatient care, including post-acute skilled care provided in swing beds (skilled swing days). Because the reimbursement formula treats swing bed and acute days equally, there is concern that CAH skilled swing days are "overreimbursed" as compared with skilled days provided in other settings. The reimbursement formula is complex; thus, empirical estimates are needed to identify the marginal cost per day to the hospital and the implied Medicare expenditure per day, accounting for fixed cost transfers between services. Read More

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30-Day risk-standardized mortality and readmission rates after ischemic stroke in critical access hospitals.

Stroke 2012 Oct 30;43(10):2741-7. Epub 2012 Aug 30.

Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8034, USA.

Background And Purpose: The critical access hospital (CAH) designation was established to provide rural residents with local access to emergency and inpatient care. CAHs, however, have poorer short-term outcomes for pneumonia, heart failure, and myocardial infarction compared with other hospitals. We assessed whether 30-day risk-standardized mortality rates (RSMRs) and risk-standardized readmission rates (RSRRs) after ischemic stroke differ between CAHs and non-CAHs. Read More

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October 2012

Medicare and Medicaid programs: hospital outpatient prospective payment; ambulatory surgical center payment; hospital value-based purchasing program; physician self-referral; and patient notification requirements in provider agreements. Final rule with comment period.

Authors:

Fed Regist 2011 Nov;76(230):74122-584

This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) for CY 2012 to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the OPPS. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system. Read More

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November 2011

Medicare and Medicaid programs; electronic health record incentive program. Final rule.

Authors:

Fed Regist 2010 Jul;75(144):44313-588

This final rule implements the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA) (Pub. L. 111-5) that provide incentive payments to eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) participating in Medicare and Medicaid programs that adopt and successfully demonstrate meaningful use of certified electronic health record (EHR) technology. Read More

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Inefficiency differences between critical access hospitals and prospectively paid rural hospitals.

J Health Polit Policy Law 2010 Feb;35(1):95-126

Widener University.

The Medicare prospective payment system (PPS) contains incentives for hospitals to improve efficiency by placing them at financial risk to earn a positive margin on services rendered to Medicare patients. Concerns about the financial viability of small rural hospitals led to the implementation of the Medicare Rural Hospital Flexibility Program (Flex Program) of 1997, which allows facilities designated as critical access hospitals (CAHs) to be paid on a reasonable cost basis for inpatient and outpatient services. This article compares the cost inefficiency of CAHs with that of nonconverting rural hospitals to contrast the performance of hospitals operating under the different payment systems. Read More

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February 2010

Impact of local resources on hospitalization patterns of Medicare beneficiaries and propensity to travel outside local markets.

J Rural Health 2010 ;26(1):20-9

Center for Primary Care, Prevention, and Clinical Partnerships, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA.

Purpose: To examine how local health care resources impact travel patterns of patients age 65 and older across the rural urban continuum.

Methods: Information on inpatient hospital discharges was drawn from complete 2004 hospital discharge files from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) for New York, California, and Florida, and the 2003 hospital discharge file for Pennsylvania. The study population was Medicare patients with admissions for ambulatory care sensitive conditions. Read More

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January 2011

Factors associated with Iowa rural hospitals' decision to convert to critical access hospital status.

J Rural Health 2009 ;25(1):70-6

Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

Context: The Balanced Budget Act (BBA) of 1997 allowed some rural hospitals meeting certain requirements to convert to Critical Access Hospitals (CAHs) and changed their Medicare reimbursement from prospective to cost-based. Some subsequent CAH-related laws reduced restrictions and increased payments, and the number of CAHs grew rapidly.

Purpose: To examine factors related to hospitals' decisions to convert and time to CAH conversion. Read More

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Use of critical access hospital emergency rooms by patients with mental health symptoms.

J Rural Health 2007 ;23(2):108-15

Maine Rural Health Research Center, Muskie School of Public Service, University of Southern Maine, Portland, ME 04104, USA.

Context: National data demonstrate that mental health (MH) visits to the emergency room (ER) comprise a small, but not inconsequential, proportion of all visits; however, we lack a rural picture of this issue.

Purpose: This study investigates the use of critical access hospital (CAH) ERs by patients with MH problems to understand the role these facilities play in rural MH needs and the challenges they face.

Methods: Primary data were collected through the combination of a telephone survey and ER visit logs. Read More

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