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12 Challenges for Public, Rural Hospitals

Cheryl Clark, for HealthLeaders Media, October 1, 2010

One in four community hospitals in the U.S. are public hospitals owned by a government and as such, face unique challenges because they tend to be smaller, less technologically equipped and treat a population that receives lower income and is more likely to be uninsured or covered by Medicaid.

That's the finding in a statistical brief by the federal Agency for Healthcare Research and Quality, which compared these 1,131 hospitals to their 2,944 private, not-for-profit counterparts and to all 5,162 community hospitals in 2008.

Additionally, those public hospitals in rural areas, 724, tended to have more patients per nurse, a lower percentage of registered nurses among licensed nurses, and more patients diagnosed with a high severity of illness than the public hospitals in metropolitan areas.

Public hospitals "play an important role in the healthcare safety net, providing care for patients who may have limited access to care elsewhere," says the report, by researchers for the agency.

"However, these institutions face unique challenges (because they) provide care for a large proportion of patients who have low income, are uninsured, or are covered by Medicaid.  They serve a critical role as teaching institutions, and are often the first choice for trauma care."

Here are some findings from the report.

Public hospitals are—

1. Smaller, averaging 126 beds compared to 190 beds for private NFP hospitals.

2. Have lower occupancy rates, 51.9% compared with 58.9%

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