2007 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.

Regional Variation in Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 12/2007
This policy brief estimates and documents the regional magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
National Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
RUPRI Center for Rural Health Policy Analysis
Date: 12/2007
This policy brief documents the national magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
State Updates on Medicare Advantage Enrollment
RUPRI Center for Rural Health Policy Analysis
Date: 12/2007
This list contains reports for each state with the number of persons enrolled in Medicare Advantage and prepaid plans in December 2005 and September 2007 in rural and urban areas.
2005 Physician Supply and Distribution in Rural Areas of the United States (Project Summary)
WWAMI Rural Health Research Center
Date: 11/2007
This summary describes the 2005 supply and distribution of physicians (including osteopathic physicians and international medical graduates), with particular emphasis on generalists in rural areas.
2005 Physician Supply and Distribution in Rural Areas of the United States (Full Report)
WWAMI Rural Health Research Center
Date: 11/2007
This study describes the 2005 supply and distribution of physicians (including osteopathic physicians and international medical graduates), with particular emphasis on generalists in rural areas.
Reliance on Independently Owned Pharmacies in Rural America
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 11/2007
This policy brief provides locations of independently owned pharmacies in rural America that are the sole sources of access to local pharmaceutical services. In more than 2,000 rural communities, the only local pharmacy is independently owned, and in 1,044 of those communities, there is no other pharmacy within 10 miles.
Spontaneous Evacuation Following a Dirty Bomb or Pandemic Influenza: Highlights From a National Survey of Urban Residents' Intended Behavior
NORC Walsh Center for Rural Health Analysis
Date: 11/2007
This policy analysis brief reports the results of a national survey to assess the evacuation intentions of urban citizens following emergency scenarios. It includes information on how likely it would be for evacuees to go to rural or urban areas and discusses the potential impact of an urban evacuation on rural areas.
Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum
Maine Rural Health Research Center
Date: 10/2007
This study examines the distribution of substance abuse treatment services across the continuum of rural and urban counties, identifying the type and intensity of services provided.
Changes in the Rural Registered Nurse Workforce From 1980 to 2004 (Final Report)
WWAMI Rural Health Research Center
Date: 10/2007
With data from 1980-2004 National Sample Surveys of Registered Nurses, and using Rural-Urban Commuting Area definitions, this study describes changes in rural and urban registered nurse demographics, education, and employment characteristics over time.
Changes in the Rural Registered Nurse Workforce From 1980 to 2004 (Project Summary)
WWAMI Rural Health Research Center
Date: 10/2007
Current and projected nationwide shortages of registered nurses (RNs) threaten access to and quality of care in most parts of the country. In rural areas, healthcare is frequently challenged by uneven distribution of healthcare providers, including nurses. This report shows changes in the rural RN workforce from 1980 to 2004.
State Initiatives Funded by the Medicare Rural Hospital Flexibility Grant Program
Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
Date: 10/2007
This report explores activities funded by the Medicare Rural Hospital Flexibility Program (Flex Program) to strengthen the rural healthcare infrastructure and discusses which activities were considered most successful by state Flex coordinators.
Health Insurance Coverage and Access to Health Care for American Indian and Alaska Native Elders
Upper Midwest Rural Health Research Center
Date: 10/2007
This policy brief reports findings from a study assessing health insurance coverage and access to healthcare among American Indian and Alaska Native elders using data from a national survey that included more than 8,300 Native elders.
Access to Cancer Services for Rural Colorectal Cancer Patients (Project Summary)
WWAMI Rural Health Research Center
Date: 10/2007
This summary provides a brief overview of findings from a study to determine how far rural and urban colorectal cancer patients travel to three types of specialty cancer care services: surgery, medical oncology consultation, and radiation oncology consultation.
Update on Rural Enrollment in Medicare Advantage: Growth Continues
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 10/2007
This policy brief provides findings about rural enrollment in the Medicare Advantage program and other prepaid plans, with state and national data.
One Year In: Sole Community Rural Independent Pharmacies and Medicare Part D (Findings Brief)
North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Date: 10/2007
This brief describes the experiences of 51 rural independently-owned pharmacies that are the sole providers of pharmacy services in their communities one year after implementation of the Medicare Part D prescription drug benefit.
The Impact of Health Insurance Coverage on Native Elder Health: Implications for Addressing the Health Care Needs of Rural Native American Elders
Upper Midwest Rural Health Research Center
Date: 10/2007
This study examines health insurance coverage and access to healthcare among American Indian and Alaska Native elders, defined as 55 years or older. The authors conclude it is essential to develop policies that address the financial, geographical, and cultural aspects that negatively impact access to culturally appropriate healthcare.
One Year In: Sole Community Rural Independent Pharmacies and Medicare Part D (Final Report)
North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Date: 09/2007
This report describes the experiences of 51 rural, independently owned pharmacies that are the sole providers of pharmacy services in their communities one year after implementation of the Medicare Part D prescription drug benefit.
Rural Hospitals' Experience With the 340B Drug Pricing Program
Policy Brief
NORC Walsh Center for Rural Health Analysis, North Carolina Rural Health Research and Policy Analysis Center
Date: 09/2007
This policy brief describes the results of surveys of rural hospitals participating in the 340B drug-pricing program and of rural eligible but non-participating hospitals. It includes information on factors affecting participation in the program and the benefits and challenges of participation.
Rural Inpatient Psychiatric Units Improve Access to Community-Based Mental Health Services, but Medicare Payment Policy a Barrier
Maine Rural Health Research Center
Date: 08/2007
This study investigates the characteristics/admission processes of inpatient psychiatric units (IPUs) in rural hospitals with less than 50 beds and the community-based services available to them when discharging patients. Reasons for developing IPUs, barriers to opening and operating a rural IPU, and factors leading some to close are also explored.
Implementing Patient Safety Initiatives in Rural Hospitals: An Evaluation of the Tennessee Rural Hospital Patient Safety Demonstration
Upper Midwest Rural Health Research Center
Date: 08/2007
The Tennessee Rural Hospital Patient Safety Demonstration project included the implementation of three patient-safety initiatives in eight rural Tennessee hospitals using a collaborative model and an evaluation of the process and tools used in the implementation to inform future rural patient safety initiatives.
Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas (Brief)
Upper Midwest Rural Health Research Center
Date: 08/2007
This policy brief reports the results of a study of rural emergency department staffing and discusses potential implications of staffing for the quality of emergency care provided in rural areas.
State Profiles of Medicaid and SCHIP in Rural and Urban Areas
North Carolina Rural Health Research and Policy Analysis Center
Date: 08/2007
This final report is one component of a larger project that includes the development of web-based State Profiles of Medicaid and SCHIP in Rural and Urban Areas. The report provides national data comparing Medicaid enrollment and expenditures in rural and urban counties.
Use of Preventive Services Among Hispanic Sub-Groups: Does One Size Fit All?
Rural and Minority Health Research Center
Date: 07/2007
This executive summary includes results from the exploration of the use of preventive health services among Mexicans, Puerto-Ricans, Cubans, and other Latinos and examined how the use of preventive services was influenced by nation of origin and by rural versus urban residence.
How Will Elimination of Hospital Bad Debt Reimbursement Affect Rural PPS Hospitals?
Policy Brief
NORC Walsh Center for Rural Health Analysis
Date: 07/2007
This policy brief examines the financial effect that changes in current Medicare bad debt payment policy, as proposed in the FY2007 budget, might have on rural hospitals.
Rural Enrollment in Medicare Advantage Growing Rapidly in 2007, Especially in Private Fee-for-Service Plans
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 07/2007
This policy brief provides findings about enrollment in the newly designed Medicare Advantage program in rural and urban areas, with state and national data.
Rural Families More Likely to Be Uninsured and Have Different Sources of Coverage
Maine Rural Health Research Center
Date: 06/2007
This research and policy brief examines patterns of health insurance coverage within rural families and compares family-level insurance status for rural and urban families.
Substance Abuse Among Rural Youth: A Little Meth and a Lot of Booze
Maine Rural Health Research Center
Date: 06/2007
This research and policy brief examines substance abuse among rural youth, with rural-urban comparisons of methamphetamine, Oxycontin, and alcohol abuse.
Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas (Final Report)
Upper Midwest Rural Health Research Center
Date: 06/2007
The purpose of this project was to describe rural emergency department staffing nationally and to assess the potential implications of staffing for the quality of emergency care provided in rural areas.
Ambulatory Care Sensitive Condition Hospitalizations Among Rural Children (Brief)
Upper Midwest Rural Health Research Center
Date: 06/2007
This brief reports results from a study examining children's inpatient hospitalizations for ambulatory care sensitive conditions, rural residence, poverty, health insurance, and physician supply. Admission rates were examined for asthma, diabetes short-term complications, gastroenteritis, urinary tract infection, and perforated appendix.
Critical Access Hospital Year 2 Hospital Compare Participation and Quality Measure Results
Policy Brief
University of Minnesota Rural Health Research Center
Date: 05/2007
This policy brief examines the second-year participation and quality measure results for critical access hospitals in the Centers for Medicare and Medicaid Services Hospital Compare public reporting database.
Overweight and Physical Inactivity Among Rural Children Aged 10-17: A National and State Portrait
Rural and Minority Health Research Center
Date: 05/2007
This report examines the issues of obesity and being overweight among children in rural and urban settings using the data from the 2003 National Survey of Children's Health.
Does Hospital Size Affect Our Ability to Accurately Identify High Quality Care in Pay-for-Performance Programs?
Upper Midwest Rural Health Research Center
Date: 05/2007
This policy brief discusses whether hospital size impacts the ability to identify hospitals' performance in a pay-for-performance demonstration project based on hospital rankings.
340B Drug Pricing Program: Results of a Survey of Participating Hospitals
NORC Walsh Center for Rural Health Analysis, North Carolina Rural Health Research and Policy Analysis Center
Date: 05/2007
This report presents survey results of pharmacy directors at rural hospitals buying discounted outpatient drugs through the 340B program. The purpose was to understand the perspectives of pharmacy directors on the 340B program, the program's financial impact, and which program features presented barriers to its broader implementation.
Preventing Hospitalizations in Depressed Rural Primary Care Patients
WICHE Center for Rural Mental Health Research
Date: 05/2007
This study investigated the substitution of higher cost hospitalization for lower cost outpatient specialty care for depression and the extent to which insurance barriers impact service substitution patterns of outpatient specialty care for depression in rural and urban areas.
Why Are Fewer Hospitals in the Delivery Business?
NORC Walsh Center for Rural Health Analysis
Date: 04/2007
This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It looks at potential causes for this trend and explores the effects of medical malpractice reforms.
Critical Access Hospital Year 2 Hospital Compare Participation and Quality Measure Results: Briefing Paper
University of Minnesota Rural Health Research Center
Date: 04/2007
This brief examines the second-year participation and quality measure results for critical access hospitals in the Centers for Medicare and Medicaid Services Hospital Compare public reporting database for hospital quality measures.
State Initiatives Funded by the Medicare Rural Hospital Flexibility Grant Program (Policy Brief)
Policy Brief
Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
Date: 04/2007
To understand the priorities/accomplishments of state Flex Grant Programs, the Flex Monitoring Team asked Flex coordinators to identify and discuss their states' three most successful initiatives in the last two years. Interviews were conducted with Flex coordinators and State Office of Rural Health staff in 45 states.
Small, Stand-Alone, and Struggling: The Adoption of Health Information Technology by Rural Hospitals
Policy Brief
NORC Walsh Center for Rural Health Analysis
Date: 04/2007
This policy brief reports findings from a national survey of rural hospitals designed to investigate how differences among the hospitals affect their implementation of health information technology.
Urban-to-Rural Evacuation: Planning for Population Surge
Policy Brief
NORC Walsh Center for Rural Health Analysis
Date: 04/2007
This policy brief discusses disaster planning and how rural preparedness officials face significant informational, organizational, and infrastructural constraints in their abilities to prepare for a potential population surge from urban areas.
Rural Enrollment in Medicare Advantage Is Concentrated in Private Fee-for-Service Plans
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2007
This policy brief provides findings about enrollment in the newly designed Medicare Advantage (MA) program in rural and urban areas. It includes rural and urban data on enrollment in MA and other prepaid plans by type of plan and provides state-level information on MA enrollment.
Allied Health Job Vacancy Tracking Report
North Carolina Rural Health Research and Policy Analysis Center
Date: 04/2007
This report quantifies workforce demand for selected allied health professions in North Carolina, tracks job vacancy advertisements in print and online sources, summarizes vacancy advertisements by profession, region, and employer type, and describes the types of sign-on bonuses offered by employers.
Health Center Expansion and Recruitment Survey 2004: Results by Health and Human Services Regions and Health Center Geography
WWAMI Rural Health Research Center
Date: 03/2007
This report presents findings from the national study of health centers' staffing, recruitment, and retention. It provides information by Health and Human Services region, urban and rural geography, and national overall estimates.
Rural Hospital Emergency Department Quality Measures: Aggregate Data Report
University of Minnesota Rural Health Research Center
Date: 03/2007
This report shares findings from a project testing emergency department (ED) quality measures in critical access hospitals in Washington state. The quality measures focused on patients presenting to the ED with chest pain/acute myocardial infarction or trauma and patients seen in the ED who were transferred to another hospital for care.
Becoming an Emergency Medical Technician: Urban-Rural Differences in Motivation and Job Satisfaction
North Carolina Rural Health Research and Policy Analysis Center
Date: 03/2007
This study uses cross-sectional data from the 2003 national Longitudinal Emergency Medical Technician Attributes and Demographic Study Project to explore urban-rural differences in why emergency medical technicians enter the field, what is important in their jobs, and whether they are satisfied with their profession.
The Washington State Nurse Anesthetist Workforce: A Case Study
Journal Article
WWAMI Rural Health Research Center
Date: 02/2007
The purpose of this study was to describe the Washington State Certified Registered Nurse Anesthetist (CRNA) workforce and analyze selected dimensions of their clinical practice.
The Community Impact of Critical Access Hospitals
Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
Date: 02/2007
This policy brief discusses the findings of a project to understand the community involvement and impact of critical access hospitals and the Medicare Rural Hospital Flexibility Program (Flex Program).
Hospital Size, Uncertainty and Pay-for-Performance
Upper Midwest Rural Health Research Center
Date: 02/2007
This report examines whether hospital size impacts the ability to identify hospitals' performance in a pay-for-performance demonstration project based on hospital rankings.
Small, Stand-Alone, and Struggling: The Adoption of Health Information Technology by Rural Hospitals (Working Paper)
NORC Walsh Center for Rural Health Analysis
Date: 02/2007
This paper reports the full findings from a national survey of rural hospitals designed to investigate how differences among the hospitals affect their implementation of health information technology.
A National Study of Lifetime Asthma Prevalence and Trends in Metro and Non-Metro Counties, 2000-2003 (Project Summary)
WWAMI Rural Health Research Center
Date: 01/2007
This summary provides a brief overview of the findings from a study of the prevalence of and recent trends in asthma among adults residing in metropolitan and non-metropolitan counties in the United States.
A National Study of Lifetime Asthma Prevalence and Trends in Metro and Non-Metro Counties, 2000-2003 (Full Report)
WWAMI Rural Health Research Center
Date: 01/2007
This paper reports the findings of a study regarding the prevalence of and recent trends in asthma among adults residing in metropolitan and non-metropolitan counties in the United States.
Enrollment in Medicare Part D for Rural Beneficiaries Is Encouraging
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 01/2007
This policy brief provides updated findings about Medicare beneficiary enrollment in prescription drug plans in rural and urban areas across the United States.
North Dakota Health Care Workforce: Planning Together to Meet Future Health Care Needs
Upper Midwest Rural Health Research Center
Date: 01/2007
This policy brief details strategies for addressing health workforce needs in North Dakota. It includes examples of state health workforce pipeline strategies used in other states.
Exploring the Community Impact of Critical Access Hospitals
Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
Date: 01/2007
This paper reports on a series of site visits to six diverse rural communities and critical access hospitals to assess the experiences and impact of these hospitals in responding to their community's health infrastructure needs.
340B Drug Pricing Program: Results of a Survey of Eligible but Non-Participating Rural Hospitals
NORC Walsh Center for Rural Health Analysis, North Carolina Rural Health Research and Policy Analysis Center
Date: 01/2007
This paper summarizes the results of a 2006 survey of pharmacy directors at rural hospitals that are eligible but currently not participating in the 340B Drug Pricing Program, which enables certain types of safety-net organizations to obtain discounted outpatient medications.
Use of Preventive Services Among Hispanic Sub-Groups: Does One Size Fit All? (Fact Sheet)
Fact Sheet
Rural and Minority Health Research Center
Date: 2007
This fact sheet provides key facts on preventive health services provided to rural Hispanics.
Overweight and Physical Inactivity Among Rural Children Aged 10-17: A National and State Portrait (Fact Sheet)
Fact Sheet
Rural and Minority Health Research Center
Date: 2007
This fact sheet offers a brief overview on the issues of obesity and being overweight, physical activity, and weight-related behaviors among rural and urban children.
Variations in Financial Performance Among Peer Groups of Critical Access Hospitals
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2007
Reports findings from a study that investigated whether indicators of financial performance and condition systematically vary among peer groups of Critical Access Hospitals (CAHs).
The Experience of Rural Independent Pharmacies With Medicare Part D: Reports From the Field
Journal Article
North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Date: 2007
Describes first-hand reports from rural pharmacist-owners about their experiences with Medicare Part D plans in the first 7 months of 2006 in order to gain a more thorough understanding of the challenges faced by rural independent pharmacies as a result of program implementation.
Urban-Rural Flows of Physicians
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2007
Reports findings from a study to determine whether there was a significant flow of physicians from urban to rural areas in recent years when the overall supply of physicians has been considered in balance with needs.
Mode of Travel and Actual Distance Traveled For Medical or Dental Care By Rural and Urban Residents (Fact Sheet)
Fact Sheet
Rural and Minority Health Research Center
Date: 2007
This fact sheet addresses the cost and difficulty associated with travel for medical or dental care.
Rural/Urban Differences in Barriers to and Burden of Care for Children With Special Health Care Needs
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2007
Examines the barriers and difficulties experienced by rural families of children with special healthcare needs in caring for their children. Covers rural-urban differences in types of providers used, reasons for unmet healthcare needs, insurance and financial difficulties encountered, and the family burden of providing the child's medical care.
Intensive Care in Critical Access Hospitals
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2007
Describes the facilities, equipment, and staffing used by Critical Access Hospitals (CAHs) for intensive care, the types of patients receiving ICU care, and the perceived impact of closing the ICU on CAH staff and the local community.
Patient Bypass Behavior and Critical Access Hospitals: Implications for Patient Retention
Journal Article
FORHP-funded Individual Grantees
Date: 2007
Describes the results of a study to assess the extent of bypass for inpatient care among patients living in Critical Access Hospital (CAH) service areas, and to determine factors associated with bypass, the reasons for bypass, and what CAHs can do to retain patients locally.
Use of Critical Access Hospital Emergency Rooms by Patients With Mental Health Symptoms
Journal Article
Maine Rural Health Research Center
Date: 2007
Describes the results of a study investigating the use of critical access hospital (CAH) emergency rooms by patients with mental health problems to understand the role these facilities play in rural mental health needs and the challenges they face.