George M Holmes
Datos Biográficos
| ID | 5536385 |
|---|---|
| NOMBRE | George M Holmes |
| NOMBRES | George M |
| APELLIDO | Holmes |
| FIRMA | HOLMES G M |
| AFILIACIONES | University of North Carolina at Chapel Hill |
| ORCID | 0000-0002-6169-7847 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 57 |
| TOTAL DE CITAS | 26 |
| TOTAL COMO AUTOR | 57 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1973 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 2 |
Fixed‐to‐total cost ratio is predictive of rural hospital financial distress and closures
PURPOSE: Cost structure, the proportion of fixed-to-total costs, plays a central role in rural hospital financial viability. Rural hospitals face unique challenges due to low volumes and limited flexibility in reducing fixed costs. This study evaluated variation in cost structures across rural hospital categories and assessed whether fixed-to-total cost ratios are associated with financial distress and closure. METHODS: We analyzed 2394 rural hos…
Acute Care Utilization in Medicaid Enrollees Differs by Patient Rurality, Race, and Ethnicity
BACKGROUND: Few studies have assessed acute care utilization and health care costs among rural Medicaid enrollees in a national sample; fewer still have examined the relationship of health care utilization with different levels of rurality and enrollee race/ethnicity. OBJECTIVES: This study's objective is to compare Medicaid acute care utilization patterns by race/ethnicity and rurality interactions to identify rural populations with higher healt…
Financial Barriers to Rural Graduate Medical Education
The impact of the removal of the low‐wage index hospital policy on urban and rural hospitals
PURPOSE: The low-wage index hospital policy (LWIHP), implemented in fiscal year (FY) 2020, temporarily increased Medicare wage index values for hospitals in the lowest quartile to address geographic differences in reimbursement. Following a federal court ruling, the Centers for Medicare & Medicaid Services (CMS) rescinded the LWIHP in the FY 2025 Interim Final Rule and introduced a one-time transitional payment adjustment for hospitals experienci…
An updated model of rural hospital financial distress
PURPOSE: To create a model that predicts future financial distress among rural hospitals. METHODS: The sample included 14,116 yearly observations of 2311 rural hospitals recorded between 2013 and 2019. We randomly separated all sampled hospitals into a training set and test set at the start of our analysis. We used hospital financial performance, government reimbursement, organizational traits, and market characteristics to predict a given hospit…
A new model‐based approach for estimating rural hospital markets
PURPOSE: To provide a new approach for defining rural hospital markets. METHODS: First, we estimated models of hospital choice. We defined hospitals in the choice set using nationwide hospital data from the Healthcare Cost Report Information System (HCRIS). We modeled hospital choice using conditional logit regression and 2019 Medicare Fee-for-Service (FFS) claims data from the Centers for Medicare & Medicaid Services (CMS) Virtual Research Data …
Characteristics of Hospitals by Graduate Medical Education Expense Category
Supporting Critical Access Hospital operational and financial improvement through the Medicare Rural Hospital Flexibility Program
The authors have no conflict of interest to disclose
Bolstering the rural physician workforce in underserved communities
PURPOSE: The purpose of this study is to describe the characteristics of Rural Residency Planning and Development (RRPD) Programs, compare the characteristics of counties with and without RRPD programs, and identify rural places where future RRPD programs could be developed. METHODS: The study sample comprised 67 rural sites training residents in 40 counties in 24 US states. Descriptive statistics were used to describe RRPD programs and logistic …
Impact of rural hospital closures on hospitalizations and associated outcomes for ambulatory and emergency care sensitive conditions
PURPOSE: The purpose of this paper is to examine the impact of rural hospital closures on age-adjusted hospitalization rates for ambulatory care sensitive condition (ACSC) and emergency care sensitive condition (ECSC) and associated outcomes, such as length of stay and in-hospital mortality in hospital service areas (HSAs) that utilized the closed hospital. METHODS: We used the State Inpatient Data from the Healthcare Cost and Utilization Project…
Trends in rural‐urban disparities among surgical specialties treating cancer, 2004‐2017
PURPOSE: We evaluated temporal trends in rural-urban disparities of the surgeon supply among surgeons commonly treating patients with cancer. METHODS: We performed a retrospective observational study of county-level workforce changes from 2004 to 2017 using the Area Health Resource File. We calculated physician density (providers/100,000 population) for each specialty by rural and urban counties using the 2003 Rural-Urban Commuting Codes (RUCC), …
For Rural Hospitals That Merged, Inpatient Charges Decreased and Outpatient Charges Increased
PURPOSE: To determine whether inpatient and outpatient charges changed at rural hospitals after a merger. METHODS: Hospital mergers were derived from proprietary Irving Levin Associates data through manual review and validation. Hospital-level characteristics were derived from HCRIS, CMS Impact File Hospital Inpatient Prospective Payment System, Hospital MSA file, AHRF, and US Census data. A difference-in-differences approach was used to determin…
Decline in Inpatient Volume at Rural Hospitals
PURPOSE: To investigate (1) all-payer inpatient volume changes at rural hospitals and (2) whether trends in inpatient volume differ by organizational and geographic characteristics of the hospital and characteristics of the patient population. METHODS: We used a retrospective, longitudinal study design. Our study sample consisted of rural hospitals between 2011 and 2017. Inpatient volume was measured as inpatient average daily census (ADC). Addit…
Which Definition of Rurality Should I Use
BACKGROUND: The federal government uses multiple definitions for identifying rural communities based on various geographies and different elements of rurality. OBJECTIVES: The objectives of this study were to: (1) assess the degree to which rural definitions identify the same areas as rural; and (2) assess rural-urban disparities identified by each definition across socioeconomic, demographic, and health access and outcome measures. RESEARCH DESI…
What Characteristics Influence Whether Rural Beneficiaries Receiving Care From Urban Hospitals Return Home for Skilled Nursing Care
PURPOSE: Skilled nursing care (SNC) provides Medicare beneficiaries short-term rehabilitation from an acute event. The purpose of this study is to assess beneficiary, market, and hospital factors associated with beneficiaries receiving care near home. METHODS: The population includes Medicare beneficiaries who live in a rural area and received acute care from an urban facility in 2013. "Near home" was defined 3 different ways based on distances f…
Half of Rural Residents at High Risk of Serious Illness Due to Covid‐19, Creating Stress on Rural Hospitals
PURPOSE: During the COVID-19 epidemic, it is critical to understand how the need for hospital care in rural areas aligns with the capacity across states. METHODS: We analyzed data from the 2018 Behavioral Risk Factor Surveillance System to estimate the number of adults who have an elevated risk of serious illness if they are infected with coronavirus in metropolitan, micropolitan, and rural areas for each state. Study data included 430,949 survey…
Rural Hospital Mergers Increased Between 2005 and 2016—What Did Those Hospitals Look Like
The objective of this study is to determine whether key hospital-level financial and market characteristics are associated with whether rural hospitals merge. Hospital merger status was derived from proprietary Irving Levin Associates data for 2005 through 2016 and hospital-level characteristics from HCRIS, CMS Impact File Hospital Inpatient Prospective Payment System, Hospital MSA file, AHRF, and U.S. Census data for 2004 through 2016. A discret…
Transportation Barriers to Health Care in the United States
Objectives. To quantify the number of people in the US who delay medical care annually because of lack of available transportation and to examine the differential prevalence of this barrier for adults across sociodemographic characteristics and patient populations. Methods. We used data from the National Health Interview Survey (1997–2017) to examine this barrier over time and across groups. We used joinpoint regression analysis to identify signi…
What Is Rural? Challenges And Implications Of Definitions That Inadequately Encompass Rural People And Places
Monitoring and improving rural health is challenging because of varied and conflicting concepts of just what rural means. Federal, state, and local agencies and data resources use different definitions, which may lead to confusion and inequity in the distribution of resources depending on the definition used. This article highlights how inconsistent definitions of rural may lead to measurement bias in research, the interpretation of research outc…
What Should Be the Scope of a Health Network's Obligation to Respond After a Hospital Closure
As rural hospital closures become more common, many patients are left without sources of care, raising ethical questions about hospitals' and clinicians' responsibilities during and after closures. In many cases, such as the one considered in this article, hospitals have been economic hubs of some communities for many years and are obliged to consider shortterm and long-term consequences of closures on community life. This commentary suggests tha…
How Would Rural Hospitals Be Affected by Loss of the Affordable Care Act's Medicare Low‐Volume Hospital Adjustment
PURPOSE: The low-volume hospital (LVH) payment adjustment established in the Patient Protection and Affordable Care Act (ACA) of 2010 is scheduled to sunset on October 1, 2017. The purpose of this analysis was: (1) to estimate the effect of the ACA LVH adjustment on qualifying hospitals' profitability margins; and (2) to examine hospital and market characteristics of the hospitals that would be most adversely affected by the loss of the ACA LVH a…
Predicting Financial Distress and Closure in Rural Hospitals
PURPOSE: Annual rates of rural hospital closure have been increasing since 2010, and hospitals that close have poor financial performance relative to those that remain open. This study develops and validates a latent index of financial distress to forecast the probability of financial distress and closure within 2 years for rural hospitals. METHODS: Hospital and community characteristics are used to predict the risk of financial distress 2 years …
Conservation crime as political protest
This chapter explores how incidents of rural crime, especially illegal hunting, can be seen as a form of political protest, particularly against environmental regulations. It presents the theoretical and conceptual insights from historical studies of wildlife crime and applies them to current issues, drawing in particular on insights from anthropology, human geography and political science. As conservationists decry such actions as backward, unci…
The Rising Rate of Rural Hospital Closures
PURPOSE: Since 2010, the rate of rural hospital closures has increased significantly. This study is a preliminary look at recent closures and a formative step in research to understand the causes and the impact on rural communities. METHODS: The 2009 financial performance and market characteristics of rural hospitals that closed from 2010 through 2014 were compared to rural hospitals that remained open during the same period, stratified by critic…
Emergency Department Use in the US‐Mexico Border Region and Violence in Mexico
PURPOSE: This study assessed the association between homicide rates in northern Mexico and potentially avoidable use of emergency departments (ED) in the US-Mexico border region. The border region is largely rural and underserved, making the identification and correction of potential barriers to access crucial. METHODS: We used secondary data from state inpatient and ED discharge databases for California and Arizona for 2005-2010. A retrospective…
Transportation Barriers to Health Care in the United States
Objectives. To quantify the number of people in the US who delay medical care annually because of lack of available transportation and to examine the differential prevalence of this barrier for adults across sociodemographic characteristics and patient populations. Methods. We used data from the National Health Interview Survey (1997–2017) to examine this barrier over time and across groups. We used joinpoint regression analysis to identify signi…
Forward to the Basics
This article will try to show that the oxymoron is neither as flutulent nor as contrary as it may appear at first sight. The radical reconstruction of education is one that requires some significant changes from present custom, involving the reexamination of the roots of our present processes. A conservative education is one that seeks to preserve and enhance the disciplines of knowledge, the fundamental values of our society, and the elements of…
An Investigation into the Determinants of Flight Cancellations
This paper uses Bureau of Transportation data on 35 million US domestic flights between 1995 and 2001 to investigate the determinants of flight cancellations. The paper is novel in two regards, it focuses exclusively on flight cancellations, and it explores the service quality–flight revenue relationship. We find that carriers have some control over the occurrence of flight cancellations given that cancellations are significantly less likely on T…
Bringing About Change in Teachers
(1991). Bringing About Change in Teachers: Rationalistic Technology and Therapeutic Human Relations in the Subversion of Education. Curriculum Inquiry: Vol. 21, No. 1, pp. 65-90
Moral Education
Progress or Progressive Decline? A Response to Howard Russell's Review of Progress in Education by Nigel Wright
(1982). Progress or Progressive Decline? A Response to Howard Russell's Review of Progress in Education by Nigel Wright. Curriculum Inquiry: Vol. 12, No. 4, pp. 419-432
Histoires des Usines Renault. I. Naissance de la Grande Enterprise
Un Siecle de Banque Francaise
Forward to the Basics
This article will try to show that the oxymoron is neither as flutulent nor as contrary as it may appear at first sight. The radical reconstruction of education is one that requires some significant changes from present custom, involving the reexamination of the roots of our present processes. A conservative education is one that seeks to preserve and enhance the disciplines of knowledge, the fundamental values of our society, and the elements of…
Response to David Nyberg
Nyberg, in commenting on my paper on radical conservatism, examines my position through the prism of his own distinction between socialization and education. He believes that I fail to make that necessary distinction and hence produce a false synthesis, when none is either desirable or possible. Specifically, he finds faults with my reliance on the terms fit and tradition, which, perhaps, he sees as unsatisfactory analogs for socialization and ed…
Progress or Progressive Decline? A Response to Howard Russell's Review of Progress in Education by Nigel Wright
(1982). Progress or Progressive Decline? A Response to Howard Russell's Review of Progress in Education by Nigel Wright. Curriculum Inquiry: Vol. 12, No. 4, pp. 419-432
The Secondary School in Contemporary Western Society
Secondary education will provide an all-round education for the whole child. It will provide vocational competence. It will teach the young to think, to make intelligent decisions, and to learn how to learn. It will provide an apprenticeship in the disciplines of knowledge and in contemporary technology. It will provide not only equality of opportunity to a nation's youth, but ultimately, social equality within an educated, democratic society. It…
A Response to Bowers, Howard, Stanley, and Soltis
Community in Education
If Schools Matter, Can They Be Improved
Can Public Education Stand Diversity
Bringing About Change in Teachers
(1991). Bringing About Change in Teachers: Rationalistic Technology and Therapeutic Human Relations in the Subversion of Education. Curriculum Inquiry: Vol. 21, No. 1, pp. 65-90
The Classroom
A Familiar Attack
(1991). A Familiar Attack: Response to Carr and Rudduck. Curriculum Inquiry: Vol. 21, No. 1, pp. 97-103
Moral Education
Anglo–Florentine Trade in 1451
Journal Article Anglo–Florentine Trade in 1451 Get access GEORGE HOLMES GEORGE HOLMES All Souls CollegeOxford Search for other works by this author on: Oxford Academic Google Scholar The English Historical Review, Volume CVIII, Issue 427, April 1993, Pages 371–386, https://doi.org/10.1093/ehr/CVIII.427.371 Published: 01 April 1993
Intellectual Rebellion, Paradox, and Power
Synthesizing Educational Discourse
Can Schools Make Us Better
Denys Hay (1915-94)
Journal Article Denys Hay (1915-94) Get access GEORGE HOLMES GEORGE HOLMES All Souls CollegeOxford Search for other works by this author on: Oxford Academic Google Scholar The English Historical Review, Volume CX, Issue 435, February 1995, Pages 1–3, https://doi.org/10.1093/ehr/CX.435.1 Published: 01 February 1995
Reply to Thomas Kellaghan
Kellaghan is unhappy that I did not write a traditional review describing the book's purposes and contents, followed by comments on its success in achieving those purposes. Curriculum Inquiry prefers essay reviews. The essay review is intended to review broadly the issues raised by the book from the critic's perspective. At the same time, the reader should gain some understanding of what the book is about. The major argument in my review is that …
Students, Employers, Parents, and Educators—Varied Interests
Do Parents Matter
A review of The Home Environment and School Learning: Promoting Parental Involvement in the Education of Children by T. Kellaghan, K. Sloane, B. Alvarez, and B. S. Bloom. San Francisco: Jossey-Bass, 1993
How Should Educational Policymakers Address Conflicting Interests within a Diverse Society
(2000). How Should Educational Policymakers Address Conflicting Interests within a Diverse Society? Curriculum Inquiry: Vol. 30, No. 1, pp. 119-132
How Might the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Affect the Financial Viability of Rural Pharmacies? An Analysis of Preimplementation Prescription Volume and Paymen…
Context: Passage of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) has created interest in how the legislation will affect access to prescription drugs among rural beneficiaries. Policy attention has focused to a much lesser degree on the implications of the MMA for the financial viability of rural pharmacies. Purpose : This article presents descriptive information on mail‐order prescriptions, volume, and payer t…
An Investigation into the Determinants of Flight Cancellations
This paper uses Bureau of Transportation data on 35 million US domestic flights between 1995 and 2001 to investigate the determinants of flight cancellations. The paper is novel in two regards, it focuses exclusively on flight cancellations, and it explores the service quality–flight revenue relationship. We find that carriers have some control over the occurrence of flight cancellations given that cancellations are significantly less likely on T…
Medicine (28 obras) · Sociology (23 obras) · Healthcare Policy and Management (22 obras) · Business (19 obras) · Primary Care and Health Outcomes (18 obras) · Health care (17 obras) · Political science (17 obras) · Global Health Workforce Issues (15 obras) · Finance (14 obras) · Economics (13 obras)