# Provision of Definitive Care for Children in Rural Hospitals

> **NIH AHRQ K08** · SEATTLE CHILDREN'S HOSPITAL · 2024 · $142,182

## Abstract

Project Summary/Abstract
 This proposal describes a five-year research training program that will prepare Dr. McDaniel to achieve
her long-term goal of becoming an independent physician-scientist dedicated to supporting the delivery of high-
quality, equitable care to children hospitalized in rural settings. With more than 12 million children living in rural
communities in the United States and with almost half of rural counties not providing definitive general pediatric
inpatient care, children in rural areas experience both poorer health status and limited access to pediatric
healthcare infrastructure and resources relative to children from urban areas. Addressing inequity in access for
children in rural areas in the setting of scarce resources and limited infrastructure requires health policy change
and innovative initiatives. Dr. McDaniel’s project goal is to establish system-level (e.g., provider, hospital,
community) facilitators for the provision of pediatric care in rural hospitals that may improve access to and
delivery of equitable inpatient care for children in rural communities
 In the first aim of this proposal, using a difference-in-differences approach, Dr. McDaniel will determine
if there is an association between the state-level provision of cost-based reimbursement for critical access
hospitals, a federal designation to promote the retention of services within rural communities, and the
maintenance of pediatric services (1a). Then she will examine the hospital and system characteristics of rural
hospitals associated with loss, gain, or sustained provision of general pediatric inpatient services across the
US from 2010 to 2018 (1b). Together, these will identify these will identify hospital, county, and state-level
characteristics associated with sustained provision of general pediatric inpatient services in rural counties over
time. In the second aim, using a consensus methodology with key stakeholders from seven partnering rural
hospitals, Dr. McDaniel will develop an intervention-bundle to support the provision of general pediatric
inpatient care. The bundle will build off preliminary qualitative data identifying rural hospital strategies to
support care and the contextual factors identified in Aim 1. In the third aim, Dr. McDaniel will conduct a pilot
implementation trial at three rural hospitals of the developed intervention bundle. She will assess 4 primary
implementation outcomes: acceptability, feasibility, appropriateness, and adoption. These will create a
framework for future multi-site interventions evaluating the effectiveness of interventions to promote the
sustained provision of high-quality general pediatric inpatient care.
 Dr. McDaniel’s research will be supported by an outstanding group of mentors with expertise in patient-
centered outcomes research, rural healthcare disparities, qualitative and mixed-methods, and econometrics.
Her mentors are dedicated to ensuring the success of this project and her developmen...

## Key facts

- **NIH application ID:** 10903724
- **Project number:** 5K08HS028683-03
- **Recipient organization:** SEATTLE CHILDREN'S HOSPITAL
- **Principal Investigator:** Corrie Erin McDaniel
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $142,182
- **Award type:** 5
- **Project period:** 2022-09-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10903724

## Citation

> US National Institutes of Health, RePORTER application 10903724, Provision of Definitive Care for Children in Rural Hospitals (5K08HS028683-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10903724. Licensed CC0.

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