2011 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.

Environmental Workforce Characteristics in the Rural Public Health Sector (Final Report)
West Virginia Rural Health Research Center
Date: 12/2011
This project analyzed the environmental workforce characteristics of the rural public health sector to inform policy relative to coordination of rural environmental health services.
Environmental Workforce Characteristics in the Rural Public Health Sector
Policy Brief
West Virginia Rural Health Research Center
Date: 12/2011
This project analyzed the environmental workforce characteristics of the rural public health sector to inform policy relative to coordination of rural environmental health services.
Effect of Swing Bed Use on Medicare Average Daily Cost and Reimbursement in Critical Access Hospitals
North Carolina Rural Health Research and Policy Analysis Center
Date: 12/2011
This analysis estimates the average net cost to Medicare of a SNF swing day by simulating the elimination of all Medicare SNF swing bed days in CAHs in 2009.
Water Fluoridation and Dental Health Indicators in Rural and Urban Areas of the United States (Final Report)
West Virginia Rural Health Research Center
Date: 11/2011
This study investigated the availability of fluoridated water across urban-rural settings and relates measures of fluoride availability to national survey measures of dental health in adults and children.
Health Care Access and Use Among the Rural Uninsured (Research & Policy Brief)
Policy Brief
Maine Rural Health Research Center
Date: 11/2011
Using data from the 2002-2007 Medical Expenditure Panel Survey, this study examined access to care and service use among non-elderly, uninsured rural and urban residents.
Rural Medicare Advantage 2011: Enrollment Trends and Plan Characteristics
RUPRI Center for Rural Health Policy Analysis
Date: 10/2011
This paper reports findings from Centers for Medicare and Medicaid Services data analysis to examine the trends/geographic variations in Medicare Advantage (MA) plan enrollment, premiums, and market concentration by firm. The data provide an overview of the MA program in rural America and highlight key rural/urban differences within the program.
Handling the Handoff: Rural and Race-Based Disparities in Post-Hospitalization Follow-Up Care Among Medicare Beneficiaries With Diabetes
Fact Sheet
Rural and Minority Health Research Center
Date: 10/2011
This fact sheet uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America.
Higher Risk of Death in Rural Blacks and Whites Than Urbanites Is Related to Lower Incomes, Education, and Health Coverage
Journal Article
Rural and Minority Health Research Center
Date: 10/2011
Explores the degree to which lack of health insurance may contribute to high mortality rates among rural minority men and women aged 45-64.
The High Performance Rural Health Care System of the Future
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 09/2011
This project describes a future rural system that would be built on foundations of affordability, accessibility, community focus, high quality, and patient centeredness.
Patient-Centered Medical Home Services in 29 Rural Primary Care Practices: A Work in Progress
RUPRI Center for Rural Health Policy Analysis
Date: 09/2011
This brief discusses responses from 29 rural physician practices. When asked about the use of specific policies/procedures included as criteria to certify patient-centered medical homes, fewer of them would qualify in each of five domains, including access to care, population-based, quality, care management, and clinical information management.
June 2011: Rural Medicare Advantage Enrollment Update
RUPRI Center for Rural Health Policy Analysis
Date: 09/2011
This brief shows increases in enrollment into Medicare Advantage plans in rural America. The enrollment is concentrated in plans offered by three firms, especially in the types of plans with high rural enrollment, which are preferred provider organizations and private fee-for-service plans.
Will Bundling Work in Rural America? Analysis of the Feasibility and Consequences of Bundled Payments for Rural Health Providers and Patients
Policy Brief
Upper Midwest Rural Health Research Center
Date: 09/2011
This report assesses the challenges and consequences for rural providers and patients of implementing bundled payments for acute and post-acute care episodes; explores impacts on care quality under a facility-physician bundled payment system; and describes potential modifications to bundling proposals and steps that could address rural issues.
Handling the Handoff: Rural and Race-Based Disparities in Post Hospitalization Follow-Up Care Among Medicare Beneficiaries With Diabetes
Rural and Minority Health Research Center
Date: 09/2011
This report uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America.
Trends in Skilled Nursing Facility and Swing Bed Use in Rural Areas Following the Medicare Modernization Act of 2003 (Findings Brief)
North Carolina Rural Health Research and Policy Analysis Center
Date: 08/2011
This findings brief looks at whether the availability of post-acute skilled care stabilized and how and where is it being provided today now that the reimbursement policy changes begun in the late 1990s have been fully implemented.
Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions in the United States, by Insurance Type, 2000 to 2004
RUPRI Center for Rural Health Policy Analysis
Date: 08/2011
In this policy brief, we report findings from a study that used nationwide hospital inpatient discharge data to examine the trends and regional variations of rural hospital charges due to ambulatory care sensitive conditions in the United States, by insurance type, from 2000 to 2004.
Trends in the Provision of Surgery by Rural Hospitals
North Carolina Rural Health Research and Policy Analysis Center
Date: 07/2011
This findings brief describes trends in the provision of surgery by rural hospitals.
A Rural Socioeconomic Vulnerability and Resiliency Index and Associated Health Outcomes
Policy Brief
West Virginia Rural Health Research Center
Date: 07/2011
These analyses provide evidence to support the development of programs and policies that foster educational development, and economic diversity and vitality, as means of public health improvement, especially in rural areas in selected regions of the country.
Patterns of Food Insecurity, Food Availability, and Health Outcomes Among Rural and Urban Counties (Final Report)
West Virginia Rural Health Research Center
Date: 06/2011
Rural counties are disproportionately associated with high food insecurity risk relative to urban counties. Programs and policies may focus on improving food availability and access for rural populations.
Patterns of Food Insecurity, Food Availability, and Health Outcomes Among Rural and Urban Counties
Policy Brief
West Virginia Rural Health Research Center
Date: 06/2011
This project will examine rural and urban food security/availability. It will test the hypotheses that food insecurity will differ significantly between rural/urban counties and that there will be a significant relationship between food insecurity and availability and selected adverse health outcomes in non-metropolitan counties.
Independently Owned Pharmacy Closures in Rural America, 2003-2010
RUPRI Center for Rural Health Policy Analysis
Date: 06/2011
This policy brief provides information about the closure of rural, independently owned pharmacies, including pharmacies that are the sole source of access to local pharmacy services, from 2003 through 2010.
Determining Satisfaction With Access and Financial Aspects of Care for Persons Exposed to Libby Amphibole Asbestos: Rural and National Environmental Policy Implications
Journal Article
Date: 05/2011
The rural community of Libby, Montana is the epidemiological epicenter of asbestos-related disease with mortality rates 40-80 times higher when compared to rates in Montana and the U.S. Findings indicated the Libby cohort was significantly less satisfied with access and financial aspects of care.
Recent Changes in Health Insurance Coverage in Rural and Urban Areas
North Carolina Rural Health Research and Policy Analysis Center
Date: 05/2011
This findings brief compares changes in health insurance coverage for non-elderly Americans in rural areas to changes in urban areas during the recent economic recession.
Psychosocial Health Status of Persons Seeking Treatment for Exposure to Libby Amphibole Asbestos
Journal Article
FORHP-funded Individual Grantees
Date: 05/2011
A cross-sectional exploratory study was conducted to describe the psychosocial health status of persons seeking healthcare for exposure to Libby amphibole asbestos.
Trends in Skilled Nursing Facility and Swing Bed Use in Rural Areas Following the Medicare Modernization Act of 2003 (Final Report)
Rapid Response to Requests for Rural Data Analysis
Date: 04/2011
This report provides descriptive evidence on current trends in the availability and use of swing beds and skilled nursing facility services in rural areas.
March 2011: Growth in PPOs Dominates the Rural MA Market in 2011
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2011
From March 2010 to March 2011, rural Medicare Advantage (MA) enrollment in preferred provider organization (PPO) plans grew from 28% (396,006 enrollees) to 46% (702,315 enrollees) of total enrollment, while rural MA enrollment in private-fee-for-service plans fell from 38% (530,678 enrollees) to 16% (249,499 enrollees).
Use of Health Information Technology in Support of Patient-Centered Medical Homes Is Low Among Non-Metropolitan Family Medicine Practices
RUPRI Center for Rural Health Policy Analysis
Date: 04/2011
Are physician practices, especially non-metropolitan primary care practices, ready to become patient-centered medical homes? We use a nationwide survey of physician practices to partially answer this question, focusing on the use of health information technology.
Place-Based Policies and Public Health: The Road to Healthy Rural People and Places
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 03/2011
This paper identifies how the Patient Protection and Affordable Care Act of 2010 can influence the determinants of health and contribute to the prosperity, equity, sustainability, and livability of rural places.
A Rural Socioeconomic Risk and Resiliency Inventory and Associated Health Outcomes (Final Report)
West Virginia Rural Health Research Center
Date: 03/2011
Rural areas, especially in the Southeast, Appalachia, and parts of the West, have worse VRI (Vulnerability and Resiliency Index) scores, which are a measure of six socioeconomic indicators across counties in the United States.
Care Transitions: "Time to Come Home"
Policy Brief
Upper Midwest Rural Health Research Center
Date: 03/2011
This policy brief examines care coordination, with a focus on the transitions from inpatient care back to the rural community, and suggests ways of measuring the quality of care coordination on discharge from the hospital.
Care Transitions: "Time to Come Home" (Full Report)
Upper Midwest Rural Health Research Center
Date: 03/2011
This report looks at care coordination for rural patients, with a focus on transitions from inpatient care back to the rural community, and suggests ways of measuring the quality of care coordination on discharge from the hospital.
Meaningful Use of Health Information Technology by Rural Hospitals
Journal Article
University of Minnesota Rural Health Research Center
Date: 01/2011
This study examines the current status of meaningful use of health information technology in Critical Access Hospitals (CAHs) and other rural and urban U.S. hospitals, and it discusses the potential role of Medicare payment incentives and disincentives in encouraging CAHs and other rural hospitals to achieve meaningful use.
Training Physicians for Rural Practice: Capitalizing on Local Expertise to Strengthen Rural Primary Care
Policy Brief
WWAMI Rural Health Research Center
Date: 01/2011
This policy brief explains the challenges of ensuring sufficient numbers of well-prepared family physicians for rural communities and describes the Rural Training Track (RTT) Technical Assistance Program, a strategy to utilize local expertise in sustaining the "1-2" RTT as a national model for training physicians for rural practice.
Medicare Beneficiary Access to Primary Care Physicians -- Better in Rural, but Still Worrisome
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 01/2011
In this policy brief, results from a large national physician survey are used to assess U.S. primary care physician and general surgeon willingness to accept Medicare patients and physician-reported reasons for not accepting Medicare patients.