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Rural Health
Research Gateway

2000 Research Publications

Browse the full list of research publications from the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

  • Redesigning the Medicare Program: An Opportunity to Improve Rural Health Care Systems?
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2000
    With this paper, the RUPRI Rural Health Panel is presenting a well-defined framework for what should be included in any discussion of Medicare policies.
  • Health Insurance in Rural America
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2000
    This brief focuses on the differences between the rural and urban uninsured.
  • Designing a Prescription Drug Benefit for Rural Medicare Beneficiaries: Principles, Criteria, and Assessment
    Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis
    Date: 08/2000
    This paper offers a rural perspective on the debate about the design/implementation of a Medicare prescription drug benefit. Background information on rural Medicare beneficiaries' need for, and access to, prescription drugs is provided, along with a set of rural-oriented principles for use in evaluating how various proposals may meet rural needs.
  • The Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System: Perspectives, Policies, and Choices
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2000
    This policy paper summarizes the positions of various rural health advocates and records the actions taken by Congress and the Health Care Financing Administration to improve the wage index. Finally, it outlines the research needed to energize the policy discussion of the uses and methods of calculating the hospital wage index.
  • Data Sources for Studying Uncompensated Care Provided by Rural Hospitals
    NORC Walsh Center for Rural Health Analysis
    Date: 08/2000
    This policy analysis brief discusses data sources related to hospitals' provision of charity and uncompensated care.
  • A Report on Enrollment: Rural Medicare Beneficiaries in Medicare+Choice Plans
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2000
    This policy brief describes the experience to date with the Medicare+Choice program, focusing on changes in enrollment and plan formation through Fall 1999.
  • Improving Prescription Drug Coverage for Rural Medicare Beneficiaries: Key Rural Considerations and Objectives for Legislative Proposals
    Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis
    Date: 06/2000
    This policy paper combines the work from current projects of the Maine Rural Health Research Center and the Rural Health Panel of the Rural Policy Research Institute to provide a statement of specific rural considerations and objectives for any proposal that would add a prescription drug benefit to the Medicare program.
  • Calculating and Using the Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2000
    This policy brief explains how the area wage index is calculated and used and identifies the major unresolved issues related to its calculation and use.
  • Potential Supply-Side Implications of the BBA Limits on Reimbursement to Provider-Based Rural Health Clinics
    NORC Walsh Center for Rural Health Analysis
    Date: 06/2000
    This policy analysis brief examines whether provider-based (typically hospital operated) rural health clinics are likely to close due to the reimbursement cap introduced by the Balanced Budget Act of 1997.
  • A Rural Assessment of Leading Proposals to Redesign the Medicare Program
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2000
    This paper provides a critique of two proposals to redesign the Medicare program: the "Medicare Preservation and Improvement Act of 1999" and "The President's Plan to Modernize and Strengthen Medicare for the 21st Century." Rural implications of the proposals are discussed.
  • Rural Home Health Agencies: The Impact of the Balanced Budget Act
    Policy Brief
    NORC Walsh Center for Rural Health Analysis
    Date: 04/2000
    This policy analysis brief examines how the characteristics of rural and urban Medicare-certified home health agencies differ, estimates the impact of interim payment system on these agencies, and discusses policy implications for a Medicare home health prospective payment system.
  • Medicare Reforms: The Rural Perspective
    NORC Walsh Center for Rural Health Analysis
    Date: 04/2000
    This policy analysis brief discusses Medicare reforms considered by the National Bipartisan Commission on the Future of Medicare (created by the Balanced Budget Act of 1997), including prescription drug coverage, funding graduate medical education, and increasing the eligibility age.
  • Rural and Urban Patterns of Home Health Use: Implications for Access Under the Interim Payment System
    Policy Brief
    NORC Walsh Center for Rural Health Analysis
    Date: 03/2000
    This policy analysis brief compares patterns of home health utilization among rural and urban Medicare beneficiaries in order to estimate the potential impact of an interim payment system on access to home care in rural areas of the country.
  • The Effect of the Doctor-Patient Relationship on Emergency Department Use Among the Elderly
    Journal Article
    WWAMI Rural Health Research Center
    Date: 01/2000
    OBJECTIVES: This study sought to determine the rate of emergency department use among the elderly and examined whether that use is reduced if the patient has a principal-care physician.
    METHODS: The Health Care Financing Administration's National Claims History File was used to study emergency department use by Medicare patients older than 65 years in Washington State during 1994. RESULTS: A total of 18.1% of patients had 1 or more emergency department visits during the study year; the rate increased with age and illness severity. Patients with principal-care physicians were much less likely to use the emergency department for every category of disease severity. After case mix, Medicaid eligibility, and rural/urban residence were controlled for, the odds ratio for having any emergency department visit was 0.47 for patients with a generalist principal-care physician and 0.58 for patients with a specialist principal-care physician.
    CONCLUSIONS: The rate of emergency department use among the elderly is substantial, and most visits are for serious medical problems. The presence of a continuous relationship with a physician--regardless of specialty--may reduce emergency department use.
  • Emergency Department Use by the Rural Elderly
    Journal Article
    WWAMI Rural Health Research Center
    Date: 2000
    This study uses Medicare data to compare emergency department (ED) use by rural and urban elderly beneficiaries. Given the similarity of diagnostic conditions associated with ED visits, rural EDs must be capable of dealing with the same range of emergency conditions as urban EDs.
  • The Distribution of Rural Female Generalist Physicians in the United States
    Journal Article
    WWAMI Rural Health Research Center
    Date: 2000
    Female physicians are underrepresented in rural areas. What impact might the increasing proportion of women in medicine have on the rural physician shortage? To begin addressing this question, we present data describing the geographic distribution of female physicians in the United States.
  • Educating Generalist Physicians for Rural Practice: How Are We Doing?
    Journal Article
    WWAMI Rural Health Research Center
    Date: 2000
    About 20 percent of Americans live in rural areas, 9 percent of physicians practice there. Physicians consistently settle in metropolitan, suburban, and other nonrural areas. This report summarizes the successes/failures of medical education and government initiatives intended to prepare and place more generalist physicians in rural practice.
  • Financing and Payment Issues in Rural Long Term Care Integration
    Report
    Maine Rural Health Research Center
    Date: 2000
    This report reviews current research and experience and identifies key policy and program considerations for integrated acute and long-term care financing in rural areas.