2020 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.

Decline in Inpatient Volume at Rural Hospitals
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 12/2020
This study examined inpatient volume in rural hospitals between 2011 and 2017. Patient population and the organizational and geographic characteristics of hospitals that were significant predictors of inpatient volume included census region, Medicare payment type, ownership type, total margin, and percent of the population in poverty.
Spatial Access to Vaccines for Children Providers in South Carolina: Implications for HPV Vaccination
Journal Article
Rural and Minority Health Research Center
Date: 12/2020
In South Carolina, rural children ages 13 to 17 years old have lower rates of HPV vaccination initiation. To better understand potential drivers of this rural-urban disparity, this study's objective was to examine spatial access to Vaccines For Children-enrolled clinics across rural and urban areas of the state.
Rural Hospitals Have Higher Percentages of Patients With COVID-19
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 12/2020
U.S. Department of Health and Human Services data were analyzed to compare the percentage of hospitalized patients with COVID-19 in rural versus urban hospitals.
Rural Hospitalizations for COVID-19: Snapshot on December 10, 2020
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 12/2020
U.S. Department of Health and Human Services data were analyzed to compare rural and urban hospitals on two metrics: 1) the percentage of hospitalized patients with COVID-19, and 2) the percentage of hospital beds occupied by patients that have COVID-19.
Association of CMS‐HCC Risk Scores With Health Care Utilization Among Rural and Urban Medicare Beneficiaries
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 12/2020
The study examines the relationship between Centers for Medicare & Medicaid Services Hierarchical Condition Categories risk scores and future healthcare utilization among rural and urban Medicare beneficiaries.
CMS Hierarchical Condition Category 2014 Risk Scores Are Lower for Rural Medicare Beneficiaries Than for Urban Beneficiaries
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 12/2020
The study investigates potential differences in rural and urban Centers for Medicare & Medicaid Services Hierarchical Condition Category risk scores by rurality, census region, and beneficiary race or ethnicity.
The Declining Scope of Practice of Family Physicians Is Limited to Urban Areas
Journal Article
Rural and Underserved Health Research Center
Date: 11/2020
The scope of practice for family medicine physicians has decreased in recent years. Using survey data, researchers compared family medicine physicians' scope of practice scores based on rural-urban status and other variables. Researchers found statistically significant decreases in scope of practice scores in urban settings.
Local Capacity for Emergency Births in Rural Hospitals Without Obstetrics Services
Journal Article
University of Minnesota Rural Health Research Center
Date: 11/2020
As increasing numbers of rural hospitals stop offering maternity care, limited information is available about local preparedness to address obstetric emergencies. This paper explores the capacity to treat obstetric emergencies encountered among rural hospitals without obstetric units.
Emergency Obstetric Training Needed in Rural Hospitals Without Obstetric Units
Policy Brief
University of Minnesota Rural Health Research Center
Date: 11/2020
This policy brief discusses the types of training identified by respondents and how those trainings may or may not meet the needs of those managing emergency obstetric situations in rural communities.
Acuity Differences Among Newly Admitted Older Residents in Rural and Urban Nursing Homes
Journal Article
Maine Rural Health Research Center
Date: 11/2020
This study found newly admitted residents of rural nursing homes were more likely to have cognitive issues/problem behaviors than those in urban facilities. Yet rural facilities admitted less complex older (age 75+) residents than urban, raising questions about the rural long-term services and supports system and capacity of rural nursing homes.
Substance Use Among Rural and Urban Youth and Young Adults
Policy Brief
Maine Rural Health Research Center
Date: 11/2020
This study uses national data to examine rural-urban differences in the rates of substance use among youth and young adults. Findings can help inform rural-specific prevention strategies and research targeting rural communities.
Risky Substance Use Behaviors Among Adults Residing in Nonmetropolitan and Metropolitan Counties in the United States, 2017-2018
Policy Brief
Rural and Underserved Health Research Center
Date: 11/2020
This brief uses nationally representative survey data to identify differences in past-30 day and past-year risky substance use among adults, including alcohol, tobacco, and illicit drugs. This data indicates some significant differences in substance use consumption.
Risky Substance Use Behaviors Among Adolescents Residing in Nonmetropolitan and Metropolitan Counties in the United States, 2017-2018
Policy Brief
Rural and Underserved Health Research Center
Date: 11/2020
This brief uses nationally representative survey data to compare past-30 day and past-year risky substance use among adolescents 12 to 17 years of age residing in metropolitan and nonmetropolitan counties. Specifically, we compared consumption of alcohol, tobacco, and other illicit substances.
Making It Work: Models of Success in Rural Maternity Care
University of Minnesota Rural Health Research Center
Date: 11/2020
The goal of this case series is to describe key factors that underlie three successful models of rural maternity care and to inform communities, clinicians, and hospitals that wish to keep obstetric services available locally.
Rural-Urban and Racial/Ethnic Trends and Disparities in Early-Onset and Average-Onset Colorectal Cancer
Journal Article
Rural and Minority Health Research Center
Date: 10/2020
The study's objective was to examine joint rural-urban differences in early onset colorectal cancer and average onset colorectal cancer incidence rates across racial/ethnic groups in the U.S.
Telehealth Use in a Rural State: A Mixed Methods Study Using Maine's All-Payer Claims Database
Journal Article
Rural Telehealth Research Center
Date: 10/2020
This study examines trends in telehealth use in Maine and identifies barriers and facilitators to its adoption. While telehealth appears to improve access to behavioral health and speech therapy services, provider shortages, lack of broadband, and restrictive Medicare and commercial coverage plans limit telehealth services use in rural areas.
Cervical Cancer Treatment Initiation and Survival: The Role of Residential Proximity to Cancer Care
Journal Article
Rural and Minority Health Research Center
Date: 10/2020
This study looked at the role drive time to cancer care facilities played on cancer treatment initiation and survival for cervical cancer patients.
Medicare Advantage Enrollment Update 2019
Policy Brief
Rapid Response to Requests for Rural Data Analysis
Date: 10/2020
The annual update on Medicare Advantage (MA) shows that both metropolitan and nonmetropolitan enrollment has continued to grow for more than 10 years. However, the rate of growth has been higher in nonmetropolitan counties for the past two years. Local Preferred Provider Organization plans account for nearly half of nonmetropolitan MA enrollment.
A National Survey of RN-to-BSN Programs: Are They Reaching Rural Students?
Journal Article
Rural and Minority Health Research Center
Date: 10/2020
This study used a national survey of RN-to-BSN programs to better understand their potential role in addressing disparities in BSN-prepared nurses in rural and urban areas. The results are needed to inform policymakers and stakeholders who are responsible for addressing the status and needs of nursing education.
Long-Term Care Planning, Preparedness, and Response Among Rural Long-Term Care Providers
Journal Article
Southwest Rural Health Research Center
Date: 09/2020
This manuscript explores how rural long-term care providers plan, prepare, and respond to slowly or rapidly unfolding disasters (i.e., hurricanes, wildfires, and environmental spills) in three U.S. geographic areas. Data includes secondary sources and semi-constructed interviews with long-term care facilities and disaster management organizations.
A Comparison of Rural and Urban Specialty Hospitals
Policy Brief
Rapid Response to Requests for Rural Data Analysis
Date: 09/2020
This brief describes key differences between specialty hospitals located in rural versus urban areas.
Telebehavioral Health Use Among Rural Medicaid Beneficiaries: Relationships With Telehealth Policies
Journal Article
Rural Telehealth Research Center
Date: 09/2020
This study assesses policy levers potentially supporting sustained use of telehealth services. Among rural Medicaid fee-for-service beneficiaries with behavioral health needs, engaging patients through informed consent within provider settings that receive facility fees may facilitate improved access to telebehavioral health services.
Racial and Ethnic Differences in Self-Rated Health Among Rural Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 09/2020
This study looks at racial and ethnic differences in self-rated health among rural residents as well as whether these differences can be explained by socio-demographic characteristics. Researchers used data from the 2011–2017 National Health Interview Survey to study differences in rural residents' self-rated health by race and ethnicity.
Urban Hospitals With a High Percentage of Inpatient Days for Rural Patients
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 09/2020
The purpose of this brief is to describe characteristics of urban hospitals with a high percentage of inpatient days for rural patients and to compare how they differ from urban hospitals with lower percentages of rural inpatient days.
Obstetric Emergencies in Rural Hospitals: Challenges and Opportunities
Policy Brief
University of Minnesota Rural Health Research Center
Date: 09/2020
The purpose of this policy brief is to describe the challenges rural hospitals face in providing emergency obstetric care and to highlight resources that could help rural hospitals more safely respond to obstetric emergencies.
Comparing the Health Workforce Provider Mix and the Distance Travelled for Mental Health Services by Rural and Urban Medicare Beneficiaries
Journal Article
WWAMI Rural Health Research Center
Date: 08/2020
This study used 2014 administrative Medicare claims data to describe the mix of health professionals who care for rural and urban patients with mood and/or anxiety disorders. It further describes where these beneficiaries received care and the one-way distance (miles) and time (minutes) they travelled to receive it.
Characteristics of U.S. Rural Hospitals by Obstetric Service Availability, 2017
Journal Article
University of Minnesota Rural Health Research Center
Date: 08/2020
This study described characteristics of rural U.S. hospitals by whether they provide labor and delivery care for pregnant patients. Researchers used the 2017 American Hospital Association Annual Survey to identify rural hospitals and detail their characteristics based on whether they provide obstetric services.
Averted Transfers in Rural Emergency Departments Using Telemedicine: Rates and Costs Across Six Networks
Journal Article
Rural Telehealth Research Center
Date: 08/2020
In a cohort of 4,324 tele-ED cases across 26 months in 65 hospitals in 6 tele-ED networks, 20% were averted transfers, and 43% of those were then routinely discharged rather than being transferred. Averted transfers saved on average $2,673 in avoidable transport costs per patient, with 63.6% of these cost savings accruing to public insurance.
Rural Versus Urban Prevalence of Intimate Partner Violence-Related Emergency Department Visits, 2009-2014
Policy Brief
Southwest Rural Health Research Center
Date: 08/2020
This project examines rural-urban disparities in the prevalence of intimate partner violence-related emergency department visits using a nationally representative sample of emergency room visits for the years 2009-2014.
Rural-Urban Differences Among Older Adults
Chartbook
University of Minnesota Rural Health Research Center
Date: 08/2020
This chartbook presents the characteristics of older adults in rural counties, as well as rural-urban differences among older adults, across four domains: demographics, socioeconomic characteristics, healthcare access and use, and health characteristics.
Access to Colorectal Cancer Screening Programs for Underserved Populations in South Carolina
Fact Sheet
Rural and Minority Health Research Center
Date: 08/2020
This fact sheet identifies existing initiatives targeting colorectal cancer screening in rural South Carolina.
Cervical Cancer and HPV Vaccination Disparities in South Carolina
Fact Sheet
Rural and Minority Health Research Center
Date: 08/2020
This fact sheet identifies existing initiatives targeting cervical cancer prevention and control in rural South Carolina.
Rural and Racial Disparities In Colorectal Cancer Incidence and Mortality In South Carolina 1996 - 2016 (Fact Sheet)
Fact Sheet
Rural and Minority Health Research Center
Date: 08/2020
This fact sheet examines the burden of colorectal cancer among South Carolina residents by urban-rural status and race/ethnicity.
Providing Maternity Care in a Rural Northern Iowa Community
University of Minnesota Rural Health Research Center
Date: 08/2020
This case study highlights how one rural hospital in northern Iowa has successfully sustained a maternity care practice and identifies opportunities for other rural hospitals and communities seeking to ensure local access to care for pregnancy and childbirth.
Nurse Practitioner Autonomy and Complexity of Care in Rural Primary Care
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2020
The increasing number of nurse practitioners (NPs) in the rural U.S. has the potential to help alleviate primary care shortages. Using a nationwide source of claims and Electronic Health Record data from 2017, this study constructs measures of NP clinical autonomy and complexity of care.
Changes in Hospital-Based Obstetric Services in Rural U.S. Counties, 2014-2018
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2020
In 2014, 54% of rural U.S. counties had no hospital-based obstetric services, following a steady decrease during the previous decade. Loss of rural maternity care is tied to adverse maternal and infant health outcomes. This study shares hospital-based obstetric service losses in rural U.S. counties from 2014 to 2018.
Mortality Among Workers Employed in the Mining Industry in the United States: A 29‐Year Analysis of the National Health Interview Survey—Linked Mortality File, 1986‐2014
Journal Article
Rural and Underserved Health Research Center
Date: 07/2020
Working in the mining industry increases the risk of chronic diseases and mortality. We investigated overall and cause‐specific mortality rates among workers employed in the mining sector in the U.S.
Changes in Care-Seeking After Rural Hospitals Merge
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 07/2020
Rural hospital mergers have increased significantly since 2010. Enhanced financial performance and improved quality are often cited as benefits, but hospital mergers can also lead to changes in the services provided by acquired hospitals. This brief estimates the use of inpatient services delivered by acquired rural hospitals following a merger.
Loss of Hospital-Based Obstetric Services in Rural Counties in the United States, 2004-2018
University of Minnesota Rural Health Research Center
Date: 07/2020
The purpose of this infographic is to show the loss of hospital-based obstetric services from 2004-2018 and how this differs by county type (micropolitan vs. noncore).
Telepharmacy Rules and Statutes: A 3-Year Update for All 50 States
Policy Brief
RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
Date: 07/2020
This policy brief analyzed administrative rules and legislative statutes governing each state's pharmacy practice. Key features of telepharmacy regulations were investigated for comparative analysis. Twenty-one states currently authorize retail telepharmacy, but between these states the regulatory activity varies considerably.
Development of a National Childhood Obesogenic Environment Index in the United States: Differences by Region and Rurality
Journal Article
Rural and Minority Health Research Center
Date: 07/2020
This study developed a novel childhood obesogenic environment index and highlighted important regional and rurality differences across U.S. counties.
Post-Acute Skilled Nursing Care Availability in Rural United States
Policy Brief
Southwest Rural Health Research Center
Date: 07/2020
This policy brief explores factors related to variations in the availability of post-acute skilled nursing care in rural areas in the U.S. The focus of this analysis is on swing bed program hospitals and skilled nursing facility post-acute skilled nursing care.
The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S. - A State-Level Analysis
Report
WWAMI Rural Health Research Center
Date: 06/2020
Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This set of data briefs describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties for every state.
Supply and Distribution of the Primary Care Workforce in Rural America: A State-Level Analysis
Report
WWAMI Rural Health Research Center
Date: 06/2020
Maintaining an adequate supply of primary care providers in the U.S. is one of the key challenges in rural health care. This study examines the 2019 supply and geographic distribution of primary care physicians, nurse practitioners, and physician assistants across rural areas of the U.S., providing state-level data briefs.
The Unique Impact of COVID-19 on Older Adults in Rural Areas
Journal Article
University of Minnesota Rural Health Research Center
Date: 06/2020
Older adults in rural areas of the U.S. face unique risks related to COVID-19, which puts them at risk of not only the virus, but of not being able to meet their healthcare, social, and basic needs. Rural/urban inequities, combined with within-rural inequities in health, healthcare, and financial resources cause particular challenges.
Supporting the Health and Wellbeing of Middle-Aged Adults Living Alone in Rural Counties
University of Minnesota Rural Health Research Center
Date: 06/2020
This report shares insights from healthcare providers in 14 rural counties with the highest rates of middle-aged adults living alone in order to inform policy and practice in how best to support the health and well-being of this demographic.
Expanding Access to HPV Vaccination in South Carolina Through Community Pharmacies: A Geospatial Analysis
Journal Article
Rural and Minority Health Research Center
Date: 06/2020
Human papillomavirus (HPV) rates are higher in rural areas. The uptake of HPV vaccination is lower among rural populations. Pharmacies may be ideal for improving vaccination access. Does spatial access to pharmacies among adolescents and young adults in South Carolina vary by rurality and geographic access to primary care providers?
Supply and Distribution of the Primary Care Workforce in Rural America: 2019
Policy Brief
WWAMI Rural Health Research Center
Date: 06/2020
Maintaining an adequate supply of primary care providers in the U.S. is one of the key challenges in rural healthcare. This study examines the 2019 supply and geographic distribution of primary care physicians, nurse practitioners, and physician assistants across rural areas of the U.S.
The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S.
Policy Brief
WWAMI Rural Health Research Center
Date: 06/2020
Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This brief describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties.
Major Depression, Treatment Receipt, and Treatment Sources Among Non-Metropolitan and Metropolitan Adults
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
This study estimates and compares the prevalence of past year depression, receipt of treatment for depression, and sources of treatment for depression between non-metropolitan and metropolitan adults.
Process of Identifying Measures and Data Elements for the HRSA School-Based Telehealth Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 06/2020
This brief details work to identify measures and develop data elements appropriate to school-based telehealth, create an Excel-based tool, and systematically collect data from grantees in the Health Resources and Services Administration's School-Based Telehealth Network Grant Program.
Rural/Urban Disparities in Utilization of Diabetes Self-Management Training to the Fee-for-Service Medicare Population
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
Diabetes self-management training (DSMT) is recommended for all newly diagnosed patients with diabetes. However, the utilization rate of DSMT is low, and geographic disparities in availability exist. This study sought to identify the extent of the rural/urban disparity in the provision of DSMT to fee-for-service Medicare beneficiaries in 2012-2016.
Rural/Urban Disparities in the Utilization of Health and Behavioral Assessments/Interventions in the Fee-for-Service Medicare Population
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
Identifying behaviors that contribute to disease and modifying them can be an important step in treatment. This study investigated geographic disparities and the availability of Health and Behavioral Assessments and Interventions services in rural and urban areas by examining fee-for-service Medicare beneficiaries in 2012-2016.
Rural/Urban Disparities in Utilization of Medical Nutrition Therapy to the Fee-for-Service Medicare Population
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
Medical Nutrition Therapy (MNT) is important in the treatment of many chronic conditions, but the availability of MNT in rural versus urban communities has not been examined. This study sought to identify the availability of MNT in rural and urban communities by examining Medicare fee-for-service beneficiaries in 2012-2016.
Factors Affecting the Likelihood of a Hospitalization Following a Diabetes-Related Emergency Department Visit: A Regional and Urban-Rural Analysis
Journal Article
Southwest Rural Health Research Center
Date: 05/2020
This study examines place-based and individual-level predictors of diabetes-related hospitalizations using 2009-2014 data from the National Inpatient Sample. Our findings indicate a higher incidence of these hospitalizations in residents of noncore areas in the South and Midwest, racial and ethnic minorities, and the uninsured population.
Differences by Rurality in Satisfaction With Care Among Medicare Beneficiaries
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2020
There are stark differences between rural and urban areas in demographic characteristics, health status, and healthcare. Yet less is known about rural‐urban differences in Medicare beneficiaries' satisfaction with care. We seek to understand rural‐urban differences in satisfaction with care for Medicare beneficiaries.
Rural-Urban Differences in Educational Attainment Among Registered Nurses: Implications for Achieving an 80% BSN Workforce
Journal Article
Rural and Minority Health Research Center
Date: 05/2020
Our primary objective was to provide updated information on rural-urban differences in educational attainment. We also examined rural-urban differences in employment type, salary, and demographics among registered nurses in different practice settings.
Access to Medicare Part D Plans: A Comparison of Metropolitan and Nonmetropolitan Areas
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 05/2020
This policy brief updates previous reports on rural activity in the Medicare Part D program. Comparisons are made across county type, within type of Part D plan (standalone and part of Medicare Advantage plans), and between the types of plans within county classifications.
Rural-Urban Residence and Mortality Among Three Cohorts of U.S. Adults
Policy Brief
Maine Rural Health Research Center
Date: 05/2020
Rural residents have a shorter life expectancy than urban residents. We analyzed national linked survey and death certificate data and found risk of death was 10% higher for rural than urban residents and has increased over time. Findings suggest the overall mortality penalty in rural areas may be partly driven by social determinants of health.
Most Rural Hospitals Have Little Cash Going Into COVID
North Carolina Rural Health Research and Policy Analysis Center
Date: 05/2020
This infographic uses Medicare Cost Report data to illustrate the type of rural hospitals most likely to struggle financially during the pandemic as measured by lower median days cash on hand.
Characteristics of Counties With the Highest Proportion of the Oldest Old
Policy Brief
University of Minnesota Rural Health Research Center
Date: 05/2020
The "oldest old," or individuals age 85 and older, are one of the fastest-growing segments of the U.S. population, yet little is known about where those individuals tend to live and what their communities are like. This information is important for planning how to best respond to and support this growing population.
Considerations for Defining Rural Places in Health Policies and Programs
Report
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 05/2020
Rural definitions in statute and policy are used to direct resources to underserved people. But changes in population behavior and census processes have led to concern about historic methods of defining rural. This paper identifies key questions, reviews rural definitions, and discusses options for reconsidering rural definitions.
Metropolitan/Nonmetropolitan COVID-19 Confirmed Cases and General and ICU Beds
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 05/2020
The spread of COVID-19 across rural areas has fueled concern about the availability of healthcare resources for dealing with the pandemic. This brief looks at a single measure of healthcare resources – hospital beds – and reports of current COVID-19 cases in a single week to assess the impact on rural facilities.
Factors Associated With Perceived Job Preparedness Among RNs: Results From a National Survey
Journal Article
Rural and Minority Health Research Center
Date: 05/2020
This article examines perceived job preparedness by demographic and professional characteristics among practicing registered nurses who completed a national survey. Rural and male nurses felt less prepared for nursing practice and may benefit from tailored educational experiences to improve perceptions of being prepared for the workforce.
Estimated Reduction in CAH Proﬁtability From Loss of Cost‐Based Reimbursement for Swing Beds
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 05/2020
The purpose of this study was to estimate the impact of potential loss of cost-based reimbursement for swing beds on Critical Access Hospital (CAH) profitability and to examine the characteristics of CAHs that would be most affected by such a change in reimbursement.
Health Care Professional Workforce Composition Before and After Rural Hospital Closure
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2020
This policy brief examines the composition of the local healthcare workforce before and after rural hospital closure to reveal any associations with discontinuation of inpatient services in rural communities.
Measure and Data Element Identification for the HRSA Evidence-Based Tele-Behavioral Health Network Program and the HRSA Substance Abuse Treatment Telehealth Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 04/2020
This brief details work to identify measures and develop data elements appropriate to tele-behavioral health, create an Excel-based tool, and collect data from grantees in the Health Resources and Services Administration's Evidence-Based Tele-Behavioral Health Network Grant Program and Substance Abuse Treatment Telehealth Network Grant Program.
Rates of Living Alone by Rurality and Age
University of Minnesota Rural Health Research Center
Date: 04/2020
In this infographic, we identify rates of living alone for all adults and within specific age groups using two classifications of rurality.
Rural and Urban Differences in Primary Care Pain Treatment by Clinician Type
Policy Brief
University of Minnesota Rural Health Research Center
Date: 04/2020
In this brief, we compare 2017 opioid prescribing rates among physicians and nurse practitioners within primary care practices and how these differ for rural versus urban areas.
Rural Hospital Participation in Medicare Accountable Care Organizations
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2020
This policy brief summarizes national and regional rates of rural hospital participation in Medicare Shared Savings Program Accountable Care Organizations (ACOs) and identifies factors associated with ACO participation.
Geographic Variation in the 2018 Profitability of Urban and Rural Hospitals
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 04/2020
This study describes the geographic variability in 2018 profitability of Critical Access Hospitals, other rural hospitals, and urban Prospective Payment System hospitals by census region, census division, and state.
Rural Hospitals With Long-Term Unprofitability
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 04/2020
The purpose of this study is to examine the characteristics of rural hospitals that had negative total margins in 2016, 2017, and 2018. We examined net patient revenue, Medicare payment classification, region, and state for 311 rural hospitals.
Understanding the Broader Context of Rural Hospitals and Profitability
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 04/2020
The intent of this infographic is to quantify rural hospital profitability in the broader context of all hospitals. This infographic compares the number of rural and urban hospitals and rural and urban operating revenue and operating income.
2016-18 Profitability of Urban and Rural Hospitals by Medicare Payment Classification
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 04/2020
This study compares the 2016-18 profitability of urban Prospective Payment System (PPS) hospitals to that of rural hospitals. Rural hospitals are further divided by size of rural PPS hospitals and by the rural Medicare payment classifications.
Patterns of Hospital Bypass and Inpatient Care-Seeking by Rural Residents
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 04/2020
Hospital bypass, the tendency of local rural residents to not seek care at their closest hospital, is thought to be a contributing factor for rural hospital closure. The purpose of this brief is to update the knowledge base of determinants of bypass behavior by analyzing state inpatient data from 2014-2016.
Estimating the Prevalence and Spatial Clusters of Coal Workers' Pneumoconiosis Cases Using Medicare Claims Data, 2011‐2014
Journal Article
Rural and Underserved Health Research Center
Date: 03/2020
Workers in the coal mining sector are at increased risk of respiratory diseases, including coal workers' pneumoconiosis (CWP). We investigated the prevalence of CWP and its association with sociodemographic factors among Medicare beneficiaries. We found evidence of significant spatial clustering of CWP in the states and population analyzed.
Occupancy Rates in Rural and Urban Hospitals: Value and Limitations in Use as a Measure of Surge Capacity
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 03/2020
The purpose of this brief is to provide healthcare leaders and policymakers with information about historic occupancy rates (the percent of available beds that are occupied) as an input for state and system-level planning to manage population health during a pandemic.
Healthy People 2020 Progress for Leading Causes of Death in Rural and Urban America: A Chartbook
Chartbook
Southwest Rural Health Research Center
Date: 03/2020
The purpose of this project is to conduct a midterm examination of urban versus rural disparities in meeting Healthy People 2020 mortality objectives for the top 10 leading causes of death in the U.S.
Identifying Measures and Data Elements for the HRSA Evidence-Based Tele-Emergency Network Grant Program
Policy Brief
Rural Telehealth Research Center
Date: 03/2020
This brief details multi-project work to identify measures and develop data elements appropriate to emergency department-based telehealth, create an Excel-based tool, and systematically collect data from grantees in the Health Resources and Services Administration Evidence-Based Tele-Emergency Network Grant Program.
Emergency Department Telemedicine Consults Are Associated With Faster Time-to-ECG and Time-to-Fibrinolysis for Myocardial Infarction Patients
Journal Article
Rural Telehealth Research Center
Date: 02/2020
Acute myocardial infarction (AMI) is a common, deadly emergency requiring rapid diagnosis and treatment. In this rural cohort, emergency department-based telemedicine was associated with improved timeliness of electrocardiogram and fibrinolysis. This study adds to evidence that telemedicine can improve timeliness of AMI care in rural hospitals.
Variation in Use of Home Health Care Among Fee-for-Service Medicare Beneficiaries by Rural-Urban Status and Geographic Region: Assessing the Potential for Unmet Need
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2020
This study describes use of home healthcare by rural-urban status and geographic region. Findings suggest geographic region drives variation more than rural-urban status. Unmet need may be highest in the most remote rural counties and rural counties within the West North Central, East North Central, Mountain, and Pacific Census Divisions.
Are Rural Infants Benefiting From Woman, Infants, and Children (WIC) Food Package Rule Changes? Breastfeeding and Infant Feeding Behaviors
Policy Brief
Southwest Rural Health Research Center
Date: 02/2020
This study compared breastfeeding initiation for rural and urban Women, Infants, and Children (WIC) participants before and after the changes in WIC Food Packages (WIC-FPs). In addition, changes in breastfeeding and infant feeding practices before and after changes in WIC program benefits were explored.
Health Care Use and Access Among Rural and Urban Nonelderly Adult Medicare Beneficiaries
Policy Brief
Maine Rural Health Research Center
Date: 01/2020
Little is known about the characteristics and healthcare use of rural residents with disabilities. This study compares access to and use of health services among rural and urban nonelderly Medicare beneficiaries with a disability and the factors associated with rural access issues.
Spatial Clustering Patterns and Regional Variations for Food and Physical Activity Environments Across the United States
Journal Article
Rural and Minority Health Research Center
Date: 01/2020
This study examined spatial patterns of obesogenic environments for U.S. counties. We mapped the geographic dispersion of food and physical activity (PA) environments, assessed spatial clustering, and identified differences across regions and rurality categories. This study highlights geographic clustering and disparities in food and PA access.
Travel Grant Program 2018-2019
Fact Sheet
Rural and Minority Health Research Center
Date: 01/2020
This project promoted attendance at cancer-related meetings by Rural Health Research Centers by facilitating the dissemination of information regarding important cancer meetings and handling the travel arrangements for Rural Health Research Center personnel.
Practice Predictors of Buprenorphine Prescribing by Family Physicians
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Physicians may prescribe buprenorphine if they obtain a waiver, but relatively few family physicians do so. This paper examines the association between practice characteristics and the likelihood that a family physician will prescribe buprenorphine, based on a survey of physicians seeking board certification in family medicine.
Early-Career and Graduating Physicians More Likely to Prescribe Buprenorphine
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Only a small percentage of people who need treatment for opioid use disorder receive it, including buprenorphine. This paper shows differences in rates of prescribing buprenorphine and intentions to prescribe buprenorphine between early- and mid-to-late career family physicians, based on a survey of physicians taking a certification examination.
Provider-to-Provider Telemedicine Improves Adherence to Sepsis Bundle Care in Community Emergency Departments
Journal Article
Rural Telehealth Research Center
Date: 01/2020
Sepsis is a life-threatening emergency, and timely "bundled" care improves survival. In this rural cohort, telemedicine in the emergency department (tele-ED) improved sepsis bundle adherence, including timely fluid resuscitation and antibiotic administration. Tele-ED may be a scalable intervention to improve sepsis emergency care in rural EDs.
A Bivariate Mapping Tutorial for Cancer Control Resource Allocation Decisions and Interventions
Journal Article
Rural and Minority Health Research Center
Date: 01/2020
This study demonstrates how geographic information systems software, specifically ArcGIS, can be used to develop bivariate choropleth maps to inform resource allocation and public health interventions.