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The financial viability of rural hospitals has been a matter of serious concern, with ongoing closures affecting rural residents’ access to medical services. We examined the financial viability of 1,004 US rural hospitals that had consistent rural status in 2011–17. The median overall profit margin improved for nonprofit critical access hospitals (from 2.5 percent to 3.2 percent) but declined for other hospitals (from 3.0 percent to 2.6 percent for nonprofit non–critical access hospitals, from 3.2 percent to 0.4 percent for for-profit critical access hospitals, and from 5.7 percent to 1.6 percent for for-profit non–critical access hospitals). Occupancy rate and charge markup were positively associated with overall margins: In 2017 hospitals with low versus high occupancy rates had median overall profit margins of 0.1 percent versus 4.7 percent, and hospitals with low versus high charge markups had median overall margins of 1.8 percent versus 3.5 percent. (Bai, 6/1)

In this randomized clinical trial that included 103 patients and was terminated early, the hazard ratio for time to clinical improvement within 28 days in the convalescent plasma group vs the standard treatment group was 1.40 and was not statistically significant. (Li et al, 6/3)

The intersection of the presidential election and the COVID-19 pandemic is likely to make health care reform a frequent subject of conversation in the coming months. Yet for many voters, the proposals and their implications remain hard to decipher, whether in typical years or in the midst of economic crisis. This paper describes the central issues at the heart of current health care reform proposals, with a focus on understanding that each proposal requires society to make difficult choices and appreciating the trade-offs of each choice. Evaluating the trade-offs inherent in the answers to each of five core questions is critical to understanding the philosophical underpinnings and general implications of health reform proposals. (Blumberg, 6/2)

Children of all ages appeared susceptible to COVID-19, and there was no significant sex difference. Although clinical manifestations of children’s COVID-19 cases were generally less severe than those of adult patients, young children, particularly infants, were vulnerable to infection. The distribution of children’s COVID-19 cases varied with time and space, and most of the cases were concentrated in Hubei province and surrounding areas. Furthermore, this study provides strong evidence of human-to-human transmission. (Dong et al, 6/1)

Although more than half of patients received follow-up within 7 days, variations across patient population suggest that care improvements are needed. The increased hazard of subsequent use indicates the complexity of treating these patients and points to potential opportunities to intervene at follow-up visits. (Bardach et al, 6/1)

The proportion of unnecessary antibiotic prescriptions issued by US physicians' offices and emergency departments (EDs) decreased minimally from 2010 through 2015, driven mainly by a decrease in unnecessary prescriptions for children, researchers reported yesterday in Clinical Infectious Diseases. For the study, researchers from the Centers for Disease Control and Prevention (CDC), the University of Utah, and Boston Children's Hospital used the National Ambulatory Medical Care and National Hospital Ambulatory Medical Care surveys to identify visits to physicians' offices and EDs and antibiotic prescriptions for 2010-11, 2012-13, and 2014-15. (6/3)