In the Tennessee Delta, a poor community loses its hospital — and sense of security

From the Washington Post (hat tip: Deb):

The demise of Haywood Park Community Hospital three years ago this summer added Brownsville to an epidemic of dying hospitals across rural America. Nearly 80 have closed since 2010, including nine in Tennessee, more than in any state but Texas. Many more are considered fragile — downstream victims of federal health policies, shifts in medical practice and the limited tolerance of distant corporate owners for empty beds and financial losses.

In every rural community, the ripple effects of a lost hospital are profound, reverberating beyond the inability of would-be patients to get immediate care. Many of the best jobs in town vanish. Local leaders trying to recruit new industry face an extra hurdle.

Predicting a Patient’s Future Firearm Violence Risk in the Emergency Department

From Michigan Health Lab:

“Firearm violence is a public health problem,” says Jason Goldstick, Ph.D., assistant professor of research in emergency medicine at Michigan Medicine. “At-risk youth may not have many ways to connect to violence-prevention services. This means the emergency department is a critical access point for identifying youth that are most at risk and intervening to hopefully decrease their risk of future firearm violence.”

Goldstick is the lead author of a new study based on a secondary analysis of data from a study funded by the National Institute on Drug Abuse. It’s published in Annals of Internal Medicine, and it sought to provide emergency department physicians with a new clinical risk index tool to gauge firearm violence risk among urban youth.

“If we have some indication of which of these young people are at high risk, then perhaps this could guide emergency physicians on what to do next in terms of referring them to prevention resources,” Goldstick says.

Obamacare survives, but some rural hospitals may not

From the Bridge:

Rural hospitals are especially vulnerable because they tend to run on thin profit margins and shoulder a larger share of poor patients whose coverage was projected to shrink under health care changes recently pushed by the GOP in Washington.

“There would be significant loss of insurance in rural Michigan,” said Margaret Greenwood-Ericksen, a national clinician scholar and clinical lecturer at the University of Michigan Medical School. She co-authored a January analysis of ways that repeal of the ACA could impact rural America.

“That means people can’t get access to primary care, which is critical to preventing chronic conditions from getting worse. You have conditions like diabetes and high blood pressure, which puts you at risk for stroke and heart attack,” Greenwood-Ericksen said.

And when more uninsured patients wind up in the hospital, Greenwood-Ericksen said, that strains the rural health care system by driving up the cost of uncompensated care the ACA was designed to reign in.