ETSU/NORC Rural Health Research Center

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2025

• Characteristics of Buprenorphine Therapy Among Commercially-Insured Pregnant and Postpartum Women
  This project analyzed claims from a national commercial insurance database to characterize buprenorphine therapy initiation persistence and adherence among pregnant and postpartum women with opioid use disorder (OUD) and assessed differences in buprenorphine OUD treatment characteristics among rural and urban pregnant/postpartum women.
  Topics: Healthcare access, Maternal health, Substance use and treatment
  
• Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Pre-COVID-19 and During COVID-19
  This study described and compared the differences in the utilization of emergency department (ED) services among rural and urban Medicare Fee-For-Service enrollees during 2018-2021. Researchers identified factors associated with differences in ED use, including shifts in volume, primary diagnoses, and admission source, before and since the COVID-19 public health emergency in rural and urban areas.
  Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicare, Social determinants of health
  
• Hierarchical Condition Category (HCC) Risk Scores: Designed to Predict Future Cost and Health Care Resource Use – Do They Also Accurately Reflect Differences in Health Status between Rural and Urban Beneficiaries?
  This CMS Hierarchical Condition Category (CMS-HCC) risk score study investigated differences in underlying health between rural and urban populations using recent data and analyze which factors drive observed differences.
  Topics: Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA)
  

2024

• Assessment of the Area Deprivation Index in Rural Areas
  The Area Deprivation Index (ADI) was created by University of Wisconsin researchers to provide a score for neighborhoods based on their level of disadvantage. This study characterized differences in ADI in rural vs urban areas, summarized the existing literature on ADI, and described expert considerations for utilizing the ADI for future policy.
  Topics: Frontier health, Poverty, Rural statistics and demographics, Social determinants of health
  
• Rural-Urban Analysis of Persistent Health Professional Shortage Areas
  The study described rural-urban differences in persistent Health Professional Shortage Area designations for primary care, mental health, and dental care between 2010 and 2020.
  Topics: Healthcare access, Mental and behavioral health, Oral health, Workforce
  

2023

• Examining the Burden of Public Stigma Associated with Mental Illness in the Rural U.S.
  This project quantitatively examined the burden of public stigma associated with mental illness in rural versus nonrural communities using a nationally representative panel-based survey. Findings inform strategies aimed at reducing stigma and improving the lives of those experiencing mental illness in rural communities.
  Topics: Health services, Mental and behavioral health
  
• Following the Money: Do Block Grant Resources Reach Rural Communities?
  This project applied a mixed methods design to describe the distribution of block grant resources from federal agencies through states to the local level in rural and non-rural communities in the United States. Findings could guide federal agencies and policy makers to develop strategies to more effectively target block grant resources to ensure that the needs of rural populations are addressed.
  Topics: Health services, Healthcare financing, Public health, Rural statistics and demographics
  
• Inpatient Treatment Costs Associated with Substance Use Disorders
  The purposes of this project were to examine the costs and characteristics of inpatient stays associated with substance use disorders and to examine whether there are systematic differences in these stays and costs for persons residing in rural areas compared to urban areas.
  Topics: Healthcare access, Healthcare financing, Mental and behavioral health, Substance use and treatment