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Rural Health
Research Gateway

2004 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.

  • North Dakota's Uninsured and Uncompensated Care: Costs and Coverage Options
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 11/2004
    This policy brief on health insurance coverage and the uninsured in North Dakota discusses the financial impact of uncompensated care on the healthcare system and describes several methods for expanding health insurance coverage.
  • Indian Health Care Improvement Act: Implications for North Dakota Tribes
    Upper Midwest Rural Health Research Center
    Date: 11/2004
    This policy brief provides an overview of healthcare issues facing American Indians in North Dakota, with discussion of the impact of the Indian Health Care Improvement Act.
  • Rurality and Nursing Home Quality: Results From a National Sample of Nursing Home Admissions
    Journal Article
    Southwest Rural Health Research Center
    Date: 10/2004
    There are higher percentages of elderly population in and the utilization rates of nursing homes are higher in rural areas. Overall, problems in rural nursing homes are at a much higher risk for poor outcomes, but it is most apparent in extremely isolated rural areas.
  • Rural Perspective Regarding Regulations Implementing Titles I and II of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)
    NORC Walsh Center for Rural Health Analysis, RUPRI Center for Rural Health Policy Analysis
    Date: 08/2004
    This policy paper provides, in chart form, sections of the MMA that were identified as having special concern to rural Medicare beneficiaries, medical care providers, and policy makers.
  • Rural Physicians' Acceptance of New Medicare Patients
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2004
    Findings are presented regarding rural physicians' acceptance of new Medicare patients from an analyses of national survey data of urban and rural respondents, published studies, and results of a survey of state organizations representing physicians.
  • Exploring the Impact of Medicare's Post-Acute Care Transfer Payment Policy on Rural Hospitals
    NORC Walsh Center for Rural Health Analysis
    Date: 07/2004
    This policy analysis brief describes a change in Medicare post-acute transfer payment policy and its impact on rural and urban hospitals. It includes data on the financial impact and hospital discharge behavior before and after the change.
  • Rural Implications of Medicare's Post-Acute Care Transfer Payment Policy
    NORC Walsh Center for Rural Health Analysis
    Date: 06/2004
    This study examines the behavioral and financial impacts of the initial 10-DRG policy and projects the likely financial impact of extending the policy to cover additional DRGs or discharges to swing beds.
  • Access To Primary Care and Quality of Care in Rural America
    NORC Walsh Center for Rural Health Analysis
    Date: 06/2004
    This report provides findings from a population-based study addressing the impact of the availability of healthcare resources on the rate of potentially avoidable hospitalizations. It suggests shortcomings with previous research conducted in communities that experienced problems accessing primary care services.
  • Information Technology and Rural Health Networks: An Overview of Network Practices
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2004
    This paper focuses on the use of information technology in rural health networks, based on detailed interviews with representatives for 15 rural health networks that received funding from the federal Rural Health Network Development Grant program.
  • Characterizing the General Surgery Workforce in Rural America
    WWAMI Rural Health Research Center
    Date: 05/2004
    General surgeons form a crucial component of the medical workforce in rural areas of the United States. Analysis of the data suggests that the general surgical workforce has not kept pace with the rising population, and that the number of general surgeons in most rural areas of the United States will decline further.
  • An Analysis of the Agreement of Financial Data Between the Medicare Cost Report and the Audited Hospital Financial Statement
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2004
    Few studies have examined the discrepancies between the Medicare Cost Report (MCR) and the audited hospital financial statement (FS). Findings from this study, which focused on the MCR and FS for rural hospitals, suggest that relying on a single source of financial data to assess the financial performance of rural hospitals may be inappropriate.
  • Understanding the Role of the Rural Hospital Emergency Department in Responding to Bioterrorist Attacks and Other Emergencies: A Review of the Literature and Guide to the Issues
    NORC Walsh Center for Rural Health Analysis
    Date: 04/2004
    This report reviews issues affecting rural hospitals' levels of readiness for a bioterrorist attack. Issues examined include physical capacity, sufficiency of health personnel, preparedness plans, disease surveillance systems, and communication/coordination. Concerns about funding cut across all the issues of preparedness.
  • Perspectives of Rural Hospitals on Bioterrorism Preparedness Planning
    NORC Walsh Center for Rural Health Analysis
    Date: 04/2004
    Representatives from several rural hospitals met to discuss various aspects of bioterrorist preparedness in terms of workforce and training, physical capacity and supplies, communication, and coordination with other entities.
  • Are Advanced Practice Nurses a Solution to Rural Mental Health Workforce Shortages?
    Maine Rural Health Research Center
    Date: 04/2004
    This paper summarizes the clinical skills and prescriptive authority of advanced practice psychiatric nurses and investigates current trends in their geographic distribution to determine what their future role may be in addressing rural mental health needs.
  • Rural Hospitals' Strategies for Achieving Compliance With HIPAA Privacy Requirements
    NORC Walsh Center for Rural Health Analysis
    Date: 03/2004
    Rural hospitals in this study recognized the importance of ensuring the confidentiality of patient health information and have made substantial progress in achieving compliance with HIPAA privacy standards. Each recognized that additional work will be required to effectively secure patient privacy.
  • An Analysis of Medicare's Incentive Payment Program for Physicians in Health Professional Shortage Areas
    Journal Article
    WWAMI Rural Health Research Center
    Date: 03/2004
    The Medicare Incentive Payment program provides a 10 percent bonus payment to physicians who treat patients in Health Professional Shortage Areas (HPSAs). Results show that physicians eligible for the bonus payments often did not claim them, and physicians who likely did not work in approved HPSA sites, claimed the bonus payments and received them.
  • Rural Health Research in Progress in the Rural Health Research Centers Program, 8th Edition
    Maine Rural Health Research Center
    Date: 02/2004
    This book provides policy makers with a concise source of rural health services research underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. It provides a context for legislation current and proposed that affects rural health services and populations.
  • Medicare Home Health Care in Rural America
    Policy Brief
    NORC Walsh Center for Rural Health Analysis
    Date: 01/2004
    This study looked at the characteristics of rural Medicare beneficiaries served by urban home health agencies as compared with those served by rural agencies.
  • Obesity Prevalence in Rural Counties: A National Study
    WWAMI Rural Health Research Center
    Date: 01/2004
    Using a telephone survey of adults ages 18 and older residing in states participating in the Behavioral Risk Factor Surveillance System in 1994-96 and 2000-01, researchers found that the prevalence of obesity was 23% for rural adults and 20.5% for urban adults.
  • Medicare Prescription Drug, Improvement, and Modernization Act of 2003, (P.L. 108-173): A Summary of Provisions Important to Rural Health Care Delivery
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2004
    This paper provides a wide audience of rural health policy makers, advocates, and researchers a consolidated summary of legislative provisions contained in Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108-173) that have particular meaning to the delivery of services in rural areas.
  • Financially Distressed Rural Hospitals in Four States
    NORC Walsh Center for Rural Health Analysis
    Date: 01/2004
    The effect of the outpatient prospective payment system on the financial performance of rural hospitals was simulated in four states: Iowa, Texas, Washington, and West Virginia.
  • The Migration of Physicians From Sub-Saharan Africa to the United States of America: Measures of the African Brain Drain
    Journal Article
    WWAMI Rural Health Research Center
    Date: 2004
    The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa.
    Methods: We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA.
    Results: More than 23% of America's 771 491 physicians received their medical training outside the USA, the majority (64%) in low-income or lower middle-income countries. A total of 5334 physicians from sub-Saharan Africa are in that group, a number that represents more than 6% of the physicians practicing in sub-Saharan Africa now. Nearly 86% of these Africans practicing in the USA originate from only three countries: Nigeria, South Africa and Ghana. Furthermore, 79% were trained at only 10 medical schools.
    Conclusions: Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that may be detrimental to the health systems of source countries. The migration of over 5000 doctors from sub-Saharan Africa to the USA has had a significantly negative effect on the doctor-to-population ratio of Africa. The finding that the bulk of migration occurs from only a few countries and medical schools suggests policy interventions in only a few locations could be effective in stemming the brain drain.
  • Comparative Performance Data for Critical Access Hospitals
    Journal Article
    Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center
    Date: 2004
    Discusses the potential use of comparative performance data for critical access hospitals (CPD-CAH) to facilitate performance and quality improvement. Covers potential benefits and drawbacks of CPD-CH and identifies issues in the development and implementation of CPD-CAH.
  • Quality of Care for Acute Myocardial Infarction in Rural and Urban U.S. Hospitals
    Journal Article
    WWAMI Rural Health Research Center
    Date: 2004
    Acute myocardial infarction (AMI) is a common and important cause of admission to rural hospitals, as transport of patients with AMI to urban settings can result in unacceptable delays in care. This study examines the quality of care for patients with AMI in rural hospitals with differing degrees of remoteness from urban centers.