2001 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.

Quality of Medicare Outpatient Claims Data and Its Implications for Rural Outpatient Payment Policy
NORC Walsh Center for Rural Health Analysis
Date: 12/2001
This study analyzes Medicare outpatient claims to see if the relatively poor quality of small rural hospitals' claims data have amplified the negative effects of the new payment system on small hospitals.
Patterns of Health Insurance Coverage Among Rural and Urban Children
Maine Rural Health Research Center
Date: 11/2001
This study assesses differences in the patterns of insurance coverage and uninsured spells among rural and urban children in 20 states. It also examines the implications of those differences for the design and implementation of public insurance programs.
Medicare Minus Choice: How HMO Withdrawals Affect Rural Beneficiaries
University of Minnesota Rural Health Research Center
Date: 10/2001
This report assesses the impact of Medicare HMO withdrawals and service reductions on rural Medicare beneficiaries.
Fewer Hospitals Close in the 1990s: Rural Hospitals Mirror This Trend
North Carolina Rural Health Research and Policy Analysis Center
Date: 10/2001
This findings brief summarizes a study of the number and rate of hospital closures in rural areas during the 1990s. It includes graphs and a map.
Rural Hospitals' Ability to Finance Inpatient, Skilled Nursing, and Home Health Care
University of Minnesota Rural Health Research Center
Date: 10/2001
This study surveys 448 rural hospitals to see how they are restructuring in light of the Balanced Budget Act of 1997.
Addressing Mental Health Workforce Needs in Underserved Rural Areas: Accomplishments and Challenges
Maine Rural Health Research Center
Date: 10/2001
This study reviews efforts to address mental health workforce needs in rural areas and addresses the questions: How is workforce adequacy measured? How do characteristics of communities and the mental health service delivery system challenge methods for determining workforce adequacy? What role has government played in addressing workforce needs?
Admission Severity and Mortality Rates Among Rural and Urban Nursing Facility Residents With Dementia (Research & Policy Brief)
Maine Rural Health Research Center
Date: 09/2001
This brief assesses whether the potentially higher use of nursing facility services in rural communities can be tied to differences in use patterns by older adults with dementia. Specifically, it addresses whether residents with dementia are less impaired at the time of their admission to a nursing facility than urban residents with dementia.
Comments on the June 2001 Report of the Medicare Payment Advisory Commission: Medicare in Rural America
RUPRI Center for Rural Health Policy Analysis
Date: 09/2001
This paper comments on and critiques the findings in MedPAC's Medicare in Rural America.
Medicaid Managed Behavioral Health Programs in Rural Areas
Policy Brief
Maine Rural Health Research Center
Date: 08/2001
This research and policy brief studies which states have implemented Medicaid-managed behavioral health programs in rural areas. It describes the programs in terms of Medicaid populations served, program design, and implementation model and the experience of programs regarding access to/coordination of services.
Improving the Quality of Outpatient Care for Older Patients With Diabetes: Lessons From a Comparison of Rural and Urban Communities
Journal Article
WWAMI Rural Health Research Center
Date: 08/2001
Compares the quality of diabetic care received by patients in rural and urban communities in Washington State. Concludes that large rural towns may provide the best conditions for high-quality care-growing communities that serve as regional referral centers and have an adequate, but not excessive, supply of generalist and specialist physicians.
Establishing a Fair Medicare Reimbursement for Low-Volume Rural Ambulance Providers
NORC Walsh Center for Rural Health Analysis
Date: 07/2001
This national study of ambulance transport costs looks at the advantages and disadvantages of several options for Medicare to compensate low-volume rural ambulance providers.
Access to Rural Pharmacy Services in Minnesota, North Dakota, and South Dakota
University of Minnesota Rural Health Research Center
Date: 07/2001
This paper describes the status of rural retail pharmacies in the three states; examines the availability of pharmacy services in rural areas of the states; and analyzes regulatory and policy issues that affect the delivery of pharmacy services in rural areas.
The Proximity of Rural African American and Hispanic/Latino Communities to Physicians and Hospital Services
North Carolina Rural Health Research and Policy Analysis Center
Date: 06/2001
This paper assesses how local physician concentrations and distances to hospitals differ for rural communities of varying African-American and Hispanic/Latino compositions.
Medicare Payment for Services in Rural Communities: Testimony Before the Subcommittee on Health, Committee on Ways & Means, U.S. House of Representatives
RUPRI Center for Rural Health Policy Analysis
Date: 06/2001
Reasons to change Medicare payment policies and a new framework for making appropriate changes are detailed.
Developing Affordable Non-Medical Residential Care in Rural Communities: Barriers and Opportunities
Maine Rural Health Research Center
Date: 05/2001
This study explores the challenges and opportunities for affordable non-medical residential care development in rural areas.
Proximity of Rural African-American and Hispanic/Latino Communities to Physicians and Hospital Services
North Carolina Rural Health Research and Policy Analysis Center
Date: 05/2001
This brief reports the findings of a study of how the African-American and Hispanic/ Latino composition of rural communities relates to local physician concentrations and relates to distances to hospitals offering various levels of services.
If Fewer International Medical Graduates Are Allowed in the U.S., Who Might Replace Them in Rural Underserved Areas?
North Carolina Rural Health Research and Policy Analysis Center
Date: 05/2001
This findings brief describes a study to identify rural communities that would be most affected by a decrease in availability of international medical graduates (IMGs) and perceptions of recruiters on who might replace IMGs in these areas.
How Many Physicians Can a Rural Community Support? A Practice Income Potential Model for Washington State
WWAMI Rural Health Research Center
Date: 04/2001
This report addresses the ability of smaller and underserved rural communities to financially support needed physicians. It reports on an experimental simulation model that projects potential practice income for primary care physicians in rural communities of Washington state.
Admission Severity and Mortality Rates Among Rural and Urban Nursing Facility Residents With Dementia
Maine Rural Health Research Center
Date: 03/2001
This study assesses whether the potentially higher utilization of nursing facility services in rural communities can be attributed to differences in use patterns by older adults with dementia. Specifically, it examines whether rural residents with dementia are less impaired when admitted to a nursing facility than their urban counterparts.
If Fewer International Medical Graduates Were Allowed in the U.S., Who Might Replace Them in Rural Areas?
North Carolina Rural Health Research and Policy Analysis Center
Date: 02/2001
This paper identifies rural communities that would be most affected should restrictions on international medical graduates' (IMGs') entry into the United States be tightened and reports on the perceptions of physician recruiters and health planners about who might replace IMGs currently working in such areas.
Redesigning Medicare: Considerations for Rural Beneficiaries and Health Systems
RUPRI Center for Rural Health Policy Analysis
Date: 02/2001
This book provides a framework to help shape proposals to redesign Medicare to the benefit of rural beneficiaries and providers. Chapters focus on equity, quality, choice, access, and cost.
Gender-Related Factors in the Recruitment of Generalist Physicians to the Rural Northwest
WWAMI Rural Health Research Center
Date: 02/2001
This paper examines differences in the factors female and male generalist physicians considered influential in their rural practice location choice and identifies the practice arrangements that attracted female generalist physicians to rural areas.
Financing and Payment Issues in Rural Long Term Care Integration (Research & Policy Brief)
Policy Brief
Maine Rural Health Research Center
Date: 02/2001
This research and policy brief reviews current research and experience and identifies key policy and program considerations for integrated acute and long-term care financing in rural areas.
Medicaid Managed Behavioral Health in Rural Areas
Maine Rural Health Research Center
Date: 01/2001
This study of which states have implemented Medicaid managed behavioral health (MMBH) programs in rural areas describes these programs in terms of Medicaid populations served, program design, and implementation model. It also describes the experience of programs regarding access to and coordination of services.
Development of a Research Agenda on the Issues of Access to Care and Reduction of Health Status Disparities of Rural African Americans in South Carolina
Rural and Minority Health Research Center
Date: 01/2001
This report explores disparities in health among rural African Americans and rural white South Carolina residents.
Rural Hospital Wages and the Area Wage Index: 1990-1997
North Carolina Rural Health Research and Policy Analysis Center
Date: 01/2001
This findings brief examines whether incremental changes to the hospital wage index have made it more equitable across regions and how these changes have impacted rural hospitals.
Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000: Concerns, Legislation, and Next Steps
RUPRI Center for Rural Health Policy Analysis
Date: 01/2001
This rural policy brief provides an overview of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 as it impacts rural health.
Rural Implications of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000
RUPRI Center for Rural Health Policy Analysis
Date: 01/2001
This report covers rural health policy, SCHIP Benefit Improvement Plan, and legislation.
Will the Outpatient Prospective Payment System Increase the Number of Distressed Rural Hospitals in Iowa, Texas, Washington, and West Virginia?
NORC Walsh Center for Rural Health Analysis
Date: 01/2001
This study simulates the financial impact of the outpatient prospective payment system rates and estimates the number and type of rural hospitals in the five states likely to become financially distressed as a result of its implementation.
Rural Government Role in Medicaid Managed Care: The Development of County-Based Purchasing in Minnesota
University of Minnesota Rural Health Research Center
Date: 01/2001
This paper describes the development and implementation in Minnesota of a model for rural county government participation in Medicaid-managed care initiatives.
PPS Inpatient Payment and the Area Wage Index
North Carolina Rural Health Research and Policy Analysis Center
Date: 01/2001
This fact sheet discusses how inpatient rates are calculated, the role of the wage index, and issues surrounding the wage index and reimbursement to rural hospitals by Medicare under the Prospective Payment System.
Is the Rural Safety Net at Risk? Analyses of Charity and Uncompensated Care Provided by Rural Hospitals in Washington, West Virginia, Texas, Iowa, and Vermont
NORC Walsh Center for Rural Health Analysis
Date: 01/2001
This study examines recent trends in the provision of charity care and uncompensated care by rural hospitals in five states. It also identifies rural communities whose charity and uncompensated care may diminish if their hospitals face more intense financial pressures as a result of the Balanced Budget Act.
Local Health Districts and the Public Health Workforce: A Case Study of Wyoming and Idaho
Journal Article
WWAMI Rural Health Research Center
Date: 2001
Studies personnel in local health departments (LHDs) focused on two predominantly rural states: Idaho and Wyoming. Although in the same region of the country, the structure of local public health is different in each state.
Rural Hospital Flexibility Program: The Tracking Project Reports First-Year Findings
Journal Article
WWAMI Rural Health Research Center
Date: 2001
In 1999, the Rural Hospital Flexibility Program National Tracking Team made site visits to 24 critical access hospitals (CAHs) in order to determine the extent of program implementation in the states and the approaches that states, hospitals, and communities are taking in using the Flex Program to achieve improvements in rural healthcare.
National Estimates of Physician Assistant Productivity
Journal Article
WWAMI Rural Health Research Center
Date: 2001
Analysis of productivity data from a nationally representative sample of physician assistants (PAs) showed that PAs performed 61.4 outpatient visits per week compared with 74.2 visits performed by physicians. However, productivity of PAs varies strongly across practice specialty and location.