Maine Rural Health Research Center

Current Projects

• Differences in Trauma Outcomes for Patients Residing in Ambulance Deserts
  Rural residents are 14% more likely to die after traumatic injury compared with urban residents, with distance from trauma centers and travel time likely significant contributors to this disparity. This project will use the State Emergency Department Databases and State Inpatient Database to examine differences in trauma outcomes for patients residing in ambulance deserts.
  Topics: Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics
  
• Health Care Use and Access Among Rural and Urban Elderly Medicare Beneficiaries
  This project will examine rural-urban differences in healthcare use and access to healthcare services among elderly Medicare enrollees using the 2011-2013 Medicare Current Beneficiary Survey. We also will identify the socioeconomic and health factors that may place rural seniors at risk for poor healthcare access.
  Topics: Aging, Medicare
  
• Medical and Mental Health Service Provision Amongst Rural Health Clinics
  This study will provide a descriptive analysis of differences in Rural Health Clinic (RHC) type, clinic size, and geographic location of RHCs providing same day medical and mental health visits, compared to RHCs that are only providing one or the other type of visits on the same day.
  Topics: Health services, Mental and behavioral health, Rural Health Clinics (RHCs)
  
• Mortality Risks Associated With Living in Ambulance Deserts
  This project will use ambulance data from the Maine Rural Health Research Center and from CDC WONDER to assess whether living in an ambulance desert is associated with higher mortality rates among rural and urban populations.
  Topics: Emergency medical services (EMS) and trauma, Healthcare access
  
• Out-of-Pocket Spending Among Privately Insured Rural and Urban Residents
  Out-of-pocket spending for healthcare services has been on the rise as deductibles and other cost-sharing requirements among the privately insured increase. This study compares rural and urban out-of-pocket healthcare spending to identify whether rural residents have been disproportionately affected by this trend.
  Topics: Healthcare access, Healthcare financing, Private health insurance, Public health, Uninsured and underinsured
  
• Prevalence of Opioid Prescribing, Diagnoses of Opioid Use Disorder, Treatment Patterns, and Costs Among Rural Medicare Beneficiaries
  Opioid use disorder (OUD) diagnoses among the aged and disabled are among the highest and fastest growing. This study uses the 2010-2017 Medicare Current Beneficiary Survey to examine opioid prescribing rates and explore risk factors associated with OUDs and associated treatment patterns and costs within rural and urban Medicare populations.
  Topics: Medicare, Pharmacy and prescription drugs, Substance use and treatment
  
• Psychiatric Bed Closures in Rural Hospitals: An Assessment of Trends, Impact, and Policy Strategies
  This study will examine trends in the closure of psychiatric beds by rural hospitals using the Substance Abuse and Mental Health Services Administration Treatment Services Locator; the American Hospital Association Annual Survey of Hospitals (2010-2017); and the Area Health Resources File.
  Topics: Healthcare access, Hospitals and clinics, Mental and behavioral health
  
• Public Health Insurance Coverage Among Rural and Urban Children
  Medicaid and the Children's Health Insurance Program (CHIP) are important sources of health insurance coverage for rural children, yet analyses have shown a decline in overall U.S. coverage in recent years. This study will use the American Communities Survey to examine rates of Medicaid/CHIP coverage among rural versus urban children and whether these have changed over time.
  Topics: Children and adolescents, Medicaid and CHIP
  
• Rural Poverty and Health: A Chartbook
  This chartbook will use nationally representative surveys and county-level data to provide a comprehensive overview of the health and wellbeing of rural Americans living in poverty.
  Topics: Health disparities and health equity, Health services, Healthcare access, Poverty, Rural statistics and demographics
  
• Rural-Urban Differences in Out-of-Pocket Prescription Drug Spending
  Using data from the 2014-17 Medical Expenditure Panel Survey, this study will examine rural-urban differences in out-of-pocket costs for prescription drugs. Additional analyses will examine rural-urban differences in out-of-pocket costs by type of medication and third party payer.
  Topics: Pharmacy and prescription drugs, Uninsured and underinsured
  
• Rural-Urban Differences in the Prevalence and Impact of Chronic Pain
  Limited existing evidence suggests that chronic pain may be more widespread and disabling in rural than in urban populations, and that rural residents may lack access to adequate pain treatment resources. This study will explore rural-urban differences in chronic pain prevalence, impacts, and management, and inform policies to address any identified disparities.
  Topic: Chronic diseases and conditions
  
• Socioeconomic Profiles and Market Characteristics Associated with Ambulance Deserts
  We will address the extent to which vulnerable, aging populations live in ambulance deserts and identify ambulance desert populations facing additional barriers to healthcare access. We will also assess the impact of hospital closures on travel distances to the nearest health care facilities.
  Topics: Emergency medical services (EMS) and trauma, Healthcare access, Rural statistics and demographics, Social determinants of health, Transportation
  
• Understanding Rural Health Clinic Services, Use, and Reimbursement
  This study describes the scope and intensity of services provided to Medicare beneficiaries by independent and provider-based Rural Health Clinics. It will also assess the adequacy of the Centers for Medicare & Medicaid Services' changes to the outpatient evaluation and management codes in 2021 compared to the 2021 per-visit reimbursement cap.
  Topics: Health services, Healthcare financing, Hospitals and clinics, Medicare, Rural Health Clinics (RHCs)
  
• Unmet Health and Social Needs of Rural Residents with Disability
  We will assess rural-urban differences in access to health care and social wellbeing for rural residents with a disability. Disability rates are often higher in rural areas and, given growing evidence of COVID-related disability, this study will provide critical information about the pre-pandemic status of unmet health and social needs among disabled persons to enable future planning.
  Topics: Coronavirus Disease 2019 (COVID-19), Disabilities, Health disparities and health equity, Healthcare access
  
• Use of Home and Community Based Services by Medicare Beneficiaries
  Using the Medicare Current Beneficiary Survey, we will examine rural-urban differences in the need for long term services and supports, rates of home and community-based services (HCBS) use, the use of different types of HCBS, and the impact of HCBS on subsequent use of emergent services such as hospitalizations and emergency department visits.
  Topics: Aging, Health services, Home health, Long-term care, Medicare
  
• Use of Z Codes by Rural and Urban Providers to Capture Data on the Social Determinants of Health Impacting Medicare Beneficiaries
  Using a mixed methods approach, we will examine the use of Z codes by rural and urban providers to better capture information on the social determinants of health experienced by Medicare beneficiaries across the rural continuum.
  Topics: Health services, Medicare, Physicians, Social determinants of health