2022 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.

Community Sociodemographics and Rural Hospital Survival
Journal Article
Center for Economic Analysis of Rural Health
Date: 12/2022
This study examines whether community sociodemographic factors are associated with the survival or closure of rural hospitals at risk of financial distress between 2010 and 2019.
The Evolution of Hospital Designations and Payment in the U.S.: Implications for Rural Hospitals
Report
RUPRI Center for Rural Health Policy Analysis, RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 12/2022
Medicare hospital payment policies affecting rural hospitals play a significant role in the financial viability of rural hospitals. This report provides an overview of historic and current Medicare rural hospital payment policies and alternative payment models to understand their impact on rural hospitals and the communities they serve.
A Comparison of Evidence-Based Supports for Maternal and Infant Health in 133 Rural U.S. Counties With and Without Hospital-Based Obstetric Care
University of Minnesota Rural Health Research Center
Date: 12/2022
This infographic offers a comparative look at evidence-based supports available for maternal and infant health in rural counties with recently closed obstetric units (within the past 10 years) and those with hospital-based obstetric care at the time of the survey, in 2021.
Characteristics of Rural Hospitals Eligible for Conversion to Rural Emergency Hospitals and Three Rural Hospitals Considering Conversion
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 12/2022
This brief presents 2021 data for Rural Emergency Hospital (REH)-eligible hospitals, compares financial and operational measures of three rural hospitals that have expressed interest in REH conversion to all REH-eligible hospitals, and discusses what factors may ultimately determine the number of rural hospitals that convert to REH.
Medicaid Expansion and Access to Naloxone in Metropolitan and Nonmetropolitan Areas
Journal Article
Rural and Underserved Health Research Center
Date: 11/2022
This study evaluated the association of Medicaid expansion at the state level on the number of naloxone prescriptions dispensed and the percentage paid by Medicaid. Increasing the percentage of Medicaid-paid naloxone prescriptions improved access in metro areas.
The Impact of the COVID-19 Pandemic on Rural Health Clinics' Operations and Cancer Prevention and Control Efforts
Policy Brief
Rural and Minority Health Research Center
Date: 11/2022
This study surveyed a stratified random sample of Rural Health Clinics throughout the country to examine how the pandemic has affected their overall operations and provision of cancer prevention and control services.
Rural-Urban Differences in Child and Adolescent Mental Health Prior to and During the COVID-19 Pandemic: Results From the National Survey of Children's Health
Policy Brief
Rural and Minority Health Research Center
Date: 11/2022
This policy brief analyzes data from a large national sample of children and adolescents to examine similarities and differences between rural and urban mental health outcomes prior to and during the COVID-19 pandemic and offers considerations for policy and program development.
Who Will Care for Rural Older Adults? Measuring the Direct Care Workforce in Rural Areas (policy brief)
Policy Brief
University of Minnesota Rural Health Research Center
Date: 11/2022
The policy brief examines disparities in the supply of home health aides and nursing assistants in rural areas compared to urban areas. Researchers estimate the ratio of home health aides and nursing assistants relative to the population of adults (age 65+) across rural and urban areas in the U.S.
Patterns of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 and Older, 2010-2017
Policy Brief
Maine Rural Health Research Center
Date: 11/2022
This study examines rural-urban differences in health care use among Medicare beneficiaries age 85+.
Rural Health Clinic Colorectal Cancer Screening Toolkit: A Toolkit for Implementing Evidence-Based Colorectal Cancer Screening Interventions in South Carolina Rural Health Clinics
Rural and Minority Health Research Center
Date: 11/2022
The purpose of this project is to provide evidence-based interventions and other resources to Rural Health Clinics, throughout South Carolina, to improve colorectal cancer screening among their patient population.
Rural Health Clinic Colorectal Cancer Screening Toolkit: A Toolkit for Implementing Evidence-Based Colorectal Cancer Screening Interventions in Rural Health Clinics
Rural and Minority Health Research Center
Date: 11/2022
The purpose of this project is to provide evidence-based interventions and other resources to Rural Health Clinics, throughout the United States, to improve colorectal cancer screening among their patient population.
Rural-Urban Disparities in Quality of Inpatient Psychiatric Care
Journal Article
Rural and Minority Health Research Center
Date: 11/2022
Using data from the Inpatient Psychiatric Facility Quality Reporting program 2015-2019, this study examined differences and changes in the quality of inpatient psychiatric care in rural and urban hospitals.
An Insurance Profile of Rural America: Chartbook
Chartbook
RUPRI Center for Rural Health Policy Analysis
Date: 11/2022
Over the past decade, health insurance coverage has changed in major ways in rural areas with shifts towards public and publicly subsidized coverage among the nonelderly – Medicaid, Marketplace plans – and a shift towards Medicare Advantage among those eligible for Medicare. This chartbook describes these trends in detail.
The Impact of Medicare Shared Savings Program Participation on Hospital Financial Performance: An Event-Study Analysis
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 10/2022
This study evaluated the extent to which Medicare Shared Savings Program participation affected hospital financial outcomes, including patient revenue, operating margin, different revenue source shares, and allowance and discount rate.
Association of Health Insurance, Geography, and Race and Ethnicity With Disparities in Receipt of Recommended Postpartum Care in the U.S.
Journal Article
University of Minnesota Rural Health Research Center
Date: 10/2022
This study used data from the Pregnancy Risk Assessment Monitoring System and looked at receipt of recommended postpartum care content. The study describes variations across health insurance type, rural or urban residence, and race and ethnicity.
Factors Predicting Swing Bed Versus Skilled Nursing Facility Use
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 10/2022
This study examines differences between patients discharged to swing beds versus skilled nursing facilities, stratifying by admitting hospital type (i.e., rural Critical Access Hospital versus rural Prospective Payment System hospital).
Small Rural Hospitals with Low-Volume Emergency Departments That May Convert to a Rural Emergency Hospital (REH)
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 10/2022
This study profiles rural hospitals eligible to convert to Rural Emergency Hospitals. The objective is to characterize rural hospitals with very low emergency department volume to inform the clinical and operational decisions that will be required to implement this new provider model.
Key Considerations for a Rural Hospital Assessing Conversion to Rural Emergency Hospital
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 10/2022
Based on findings from a literature review and consultation with practitioners, a conceptual framework and checklist were developed to organize and guide conversations about key considerations for conversion to a Rural Emergency Hospital.
The Involvement of Rural Health Clinic Practitioners in Cancer Treatment Decisions and Survivorship Care
Policy Brief
Rural and Minority Health Research Center
Date: 10/2022
This study examined Rural Health Clinics' practitioner involvement in cancer treatment decisions, management of side effects, surveillance, and survivorship care.
Changes in Access to Nearest Federally Qualified Health Centers and Rural Health Clinics Among Rural ZIP Codes That Did and Did Not Experience a Hospital Closure, 2006-2018
Policy Brief
Rural and Minority Health Research Center
Date: 10/2022
This brief explores changes in geographic accessibility within rural ZIP codes throughout the U.S. to Federally Qualified Health Centers and Rural Health Clinics, between 2016 and 2018.
Changes in the Supply and Rural-Urban Distribution of Social Workers in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of social workers by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Psychologists in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychologists by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Psychiatric Nurse Practitioners in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychiatric nurse practitioners by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Psychiatrists in the U.S., 1995-2019
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of psychiatrists by rural-urban status and Census Division.
Changes in the Supply and Rural-Urban Distribution of Counselors in the U.S., 2014-2021
Fact Sheet
WWAMI Rural Health Research Center
Date: 10/2022
There are rural vs. urban disparities and unequal distribution of behavioral health providers across U.S. Census Divisions. This study examined the trends in the supply of counselors by rural-urban status and Census Division.
Racial/Ethnic Disparities in Postpartum Health Insurance Coverage Among Rural and Urban U.S. Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 09/2022
Using data from the 2016-2019 Pregnancy Risk Assessment Monitoring System, this study describes postpartum health insurance coverage for rural and urban U.S. residents who are Black, Indigenous, and people of color (BIPOC) compared to those who are white.
Availability of Hospital-Based Cancer Services Before and After Rural Hospital Closure, 2008-2017
Journal Article
Rural and Minority Health Research Center
Date: 09/2022
Using American Hospital Association survey data from 2008 to 2017, the changes in access to cancer-related screening and treatment services were examined to determine the impact of hospital closures across hospital service areas.
Rural-Urban Differences in Child and Adolescent Access to and Receipt of Mental Health Services Prior to and During the COVID-19 Pandemic: Results From the National Survey of Children's Health
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This policy brief analyzes data from a large, national sample of children and adolescents to examine gross inter-group similarities and differences and offer timely recommendations for alleviating the youth mental health crisis.
Key Informant Perspectives on Supporting Health and Well-Being for LGBTQ+ Rural Residents
Policy Brief
University of Minnesota Rural Health Research Center
Date: 09/2022
This policy brief presents findings from interviews with national lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) support and advocacy organizations regarding challenges to physical and mental health and well-being for rural LGBTQ+ individuals, as well as recommendations to meet the needs of LGBTQ+ individuals in rural areas.
Examining the Burden of Public Stigma Associated With Mental Illness in the Rural United States
Policy Brief
Rural Health Equity Research Center
Date: 09/2022
Stigma is a widely recognized barrier to receipt of health and mental health services. This policy brief documents the burden of public stigma associated with any mental illness in rural versus non-rural communities in the United States. Differences in stigmatizing attitudes and beliefs by rurality, gender, race and ethnicity, and age are examined.
Review of Rural U.S. Economic and Health Care Trends
Report
Center for Economic Analysis of Rural Health
Date: 09/2022
This report reviews recent literature and publicly available data to explore important issues at the nexus of health care and local economic vibrancy. The report also explores the economic implications associated with COVID-19, however full impacts will not be known for several years.
Availability of Hospital-Based Emergency Department and Trauma Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of hospital-based emergency department and trauma services at the ZCTA level.
Availability of Nursing Homes in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of nursing homes at the ZCTA level.
Availability of Substance Use Disorder Treatment in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at spatial availability and travel burden for substance use disorder care at the ZCTA level.
Predictors of Hospital Bypass for Rural Residents Seeking Common Elective Surgery
Journal Article
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 08/2022
This article used Healthcare Cost and Utilization Project State Inpatient Databases to evaluate rates and predictors for patients bypassing rural hospitals for common procedures.
Examining the Association Between Rurality and Positive Childhood Experiences Among a National Sample
Journal Article
Rural and Minority Health Research Center
Date: 08/2022
Using the full National Survey of Children's Health with all 50 states and the District of Columbia, this study examined rural-urban differences in positive childhood experiences.
Health Insurance Marketplaces: Issuer Participation Trends in Non-Metropolitan Places, 2014-22
Policy Brief
RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
Date: 08/2022
Since the 2014 implementation of Health Insurance Marketplaces (HIMs), considerable changes have been observed in the number of insurance companies offering plans across the United States. This policy brief describes changes in HIM plan issuers over the 2014-2022 period with an emphasis on variation across metropolitan and non-metropolitan places.
Update on Rural Independently Owned Pharmacy Closures in the United States, 2003-2021
Policy Brief
RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
Date: 08/2022
Independently owned retail pharmacies in rural areas experienced a higher rate of closure than micropolitan and metropolitan areas. Closures have raised concerns about access to prescription medications as well as pharmacist-provided primary care services, which are often the sole source in rural areas for obtaining health services.
Providing High-Quality Support to Pregnant People and Their Families in Racially Diverse Rural Communities
University of Minnesota Rural Health Research Center
Date: 08/2022
The purpose of this case series is to highlight examples from racially diverse rural communities, where hospitals and health systems with obstetric units strive to meet patient needs and provide evidence-based, supportive services during pregnancy, childbirth, and the postpartum period.
Availability of Medicare-Certified Hospice Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This is one of a series of briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This brief explores access to hospice services.
Availability of Pharmacies in Minoritized Racial/Ethnic Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at access to pharmacies.
Availability of Home Health Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of home health services in minoritized racial/ethnic areas.
Medicare Beneficiary Access to Prescription Drugs in Rural Areas
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 08/2022
Declines in the number of retail pharmacies in rural areas have raised concerns about beneficiary access to prescription medications when their local pharmacy closes. The purpose of this policy brief is to identify the types of pharmacies used by beneficiaries in rural areas with limited or no access to local pharmacies.
Rural and Urban Pharmacy Presence – Pharmacy Deserts
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 08/2022
This policy brief continues the RUPRI Center's ongoing examination of the availability of community pharmacies and their provided services in rural areas of the U.S. The brief also provides a deeper analysis of counties with no retail pharmacies (i.e. pharmacy deserts) based on metropolitan/nonmetropolitan locations.
Changes in the Provision of Health Care Services by Rural Critical Access Hospitals and Prospective Payment System Hospitals in 2009 Compared to 2017
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 08/2022
The purpose of this brief is to explore changes in the availability and provision of different health care services among rural CAHs and PPS hospitals in 2009 compared to 2017.
Spatial Access to Hospital-based Obstetric Units in Minoritized Racial/Ethnic Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at spatial access to hospital-based obstetric units in minoritized racial/ethnic areas.
Higher Electronic Health Record Functionality Is Associated With Lower Operating Costs in Urban—but Not Rural—Hospitals
Journal Article
Center for Economic Analysis of Rural Health
Date: 07/2022
This study examines the relationship between electronic health record use/functionality and hospital operating costs and compares the results across rural and urban facilities.
Inequities in Availability of Evidence-Based Birth Supports to Improve Perinatal Health for Socially Vulnerable Rural Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2022
This study aimed to understand the availability of evidence-based supports and services that promote maternal and infant health, in the rural U.S. The study developed a national survey of a sample of rural hospitals and determined the county-level scores on the 2018 CDC Social Vulnerability Index for each responding hospital.
Types of Rural and Urban Hospitals and Counties Where They Are Located
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 07/2022
The purpose of this brief is to provide a snapshot of the types of rural and urban hospitals and the counties where they are located.
Increased Rates of Death From Unintentional Injury Among Non-Hispanic White, American Indian/Alaska Native, and Nonmetropolitan Communities
Policy Brief
Rural and Underserved Health Research Center
Date: 07/2022
This brief examines the rate of fatal and nonfatal unintentional injuries in nonmetropolitan and metropolitan areas, with a focus on the effects of race/ethnicity.
Changes in Access to Community Health Services Among Rural Areas Affected and Unaffected by Hospital Closures Between 2006 and 2018: A Comparative Interrupted Time Series Study
Journal Article
Rural and Minority Health Research Center
Date: 07/2022
In this article, investigators compared access to Federally Qualified Health Centers and Rural Health Clinics by those in rural areas affected versus those in rural areas unaffected by hospital closures.
County-Level Availability of Obstetric Care and Economic Implications of Hospital Closures on Obstetric Care
Policy Brief
Center for Economic Analysis of Rural Health
Date: 07/2022
This policy brief draws out demographic and economic differences between counties with obstetric care facilities and those without. It provides descriptive data on the economic changes underway in counties that lost obstetric care facilities between 2012 and 2019.
Rural Children With 4+ Adverse Childhood Experiences Often Lack Positive Experiences
Fact Sheet
Rural and Minority Health Research Center
Date: 07/2022
This research explored the proportion of rural children with adverse childhood experiences who lack positive childhood experience exposure.
Nursing Homes in Rural America: A Chartbook
Chartbook
RUPRI Center for Rural Health Policy Analysis
Date: 07/2022
Closure of nursing homes and hospitals with swing beds in recent years has changed the availability of post-acute and long-term care services in rural areas. This study examines the availability of post-acute and long-term care services as well as characteristics of residents and nursing homes in noncore, micropolitan, and metropolitan counties.
Racial Inequities in the Availability of Evidence-Based Supports for Maternal and Infant Health in 93 Rural U.S. Counties With Hospital-Based Obstetric Care
Policy Brief
University of Minnesota Rural Health Research Center
Date: 07/2022
This policy brief examines racial disparities in rural maternal and infant health outcomes between majority-Black, Indigenous, and People of Color versus majority-white rural counties and examines the availability of maternal and infant health evidence-based supports.
Self-Rated Health Among Gay, Lesbian, and Bisexual Adults: Rural/Urban Differences
Policy Brief
University of Minnesota Rural Health Research Center
Date: 07/2022
Research has documented worse health outcomes and constrained access to care for lesbian, gay, and bisexual adults. Rural residents also experience persistent disparities in health and access to care. This policy brief examines differences in self-rated health by sexual orientation and rural/urban location.
Improving Access to LGBTQIA+-Friendly Care in Rural Areas
University of Minnesota Rural Health Research Center
Date: 06/2022
The purpose of this case series is to highlight organizations doing exemplary work to improve access to and experiences of health care among lesbian, gay, bisexual, transgender, queer/questioning, and asexual/agender (LGBTQIA+) individuals in rural communities across the U.S.
Rural Community Organizations Building Inclusive Environments for LGBTQ+ Residents
University of Minnesota Rural Health Research Center
Date: 06/2022
The purpose of this case series is to highlight rural organizations doing exemplary work to build community among lesbian, gay, bisexual, transgender, and queer/ questioning residents, and create a more inclusive environment in their communities.
Anxiety, Depression, and Access to Mental Health Care by Sexual Orientation and Rurality
Policy Brief
University of Minnesota Rural Health Research Center
Date: 06/2022
This policy brief addresses the research gap among rural sexual minorities by illuminating differences in mental health for two of the most common mental health disorders (depression and anxiety), as well as differences in access to health care.
Prevalence of Chronic Conditions by Sexual Orientation and Rural-Urban Location
Policy Brief
University of Minnesota Rural Health Research Center
Date: 06/2022
This policy brief examines rates of individual chronic conditions, as well as differences in the number of chronic conditions by sexual orientation and rural-urban location.
Social and Emotional Support During the COVID-19 Pandemic by Sexual Orientation and Rurality
Policy Brief
University of Minnesota Rural Health Research Center
Date: 06/2022
This brief identifies differences in social and emotional support and changes to that support during the COVID-19 pandemic by rurality and sexual orientation.
Small-Town Pride Celebrations Supporting Social Connectedness & Well-Being for LGBTQ+ Rural Residents
University of Minnesota Rural Health Research Center
Date: 06/2022
The purpose of this case series is to highlight organizations in two states doing exemplary work to celebrate and affirm lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals in their rural communities through Pride events. These may serve as examples to others considering this work.
Non-Metropolitan and Metropolitan Trends in Mental Health Treatment Availability in Community Health and Community Mental Health Centers
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2022
This study shows how the supply of community mental health centers (CMHCs) and community health centers (CHCs) delivering mental health services changed from 2000 to 2019. While the supply of CHCs offering mental health services increased, the supply of CMHCs decreased.
The Racial and Ethnic Diversity of the Family Physician Workforce in Non-Metropolitan and Metropolitan Counties
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2022
Racial/ethnic concordance of clinicians and patients may improve health outcomes by increasing access to care for underserved populations. Our objective was to determine the distribution of family physicians (FPs) in rural areas by race/ethnicity and also whether rural minority FPs were more likely to be in underserved rural areas.
Approaches to Serving Rural Older Adults in State Plans on Aging: A Policy Content Evaluation
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2022
In this article, we share a policy content evaluation of State Plans on Aging from all 50 U.S. states, focusing on how the states will serve older adults and including common and innovative approaches to doing so.
Social Isolation and Safety Issues Among Rural Older Adults Living Alone: Perspectives of Meals on Wheels Programs
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2022
In this article, we share results from a survey of 42 Meals on Wheels programs in rural areas across the US. Respondents highlighted challenges to meeting both social and safety needs of rural older adults living alone, as well as policy recommendations to improve the health and safety of older adults living alone in rural areas.
Trends in Revenue Sources Among Rural Hospitals
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 05/2022
Possible issues with existing rural hospital financing models suggest that outpatient-centric payment methods may be more effective in providing financial relief to rural hospitals. Given this, we explored the financial importance of outpatient care to rural hospitals by estimating changes in outpatient care as a source of revenue.
Association Between Rural Hospital Service Changes and Community Demographics
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 05/2022
Research has shown that among rural communities, those with a larger percentage of Black or Hispanic residents were more likely to experience a local hospital closure. This brief explores possible associations between the proportion of a rural community belonging to a AHRQ-identified priority population and local hospital service changes.
Community Characteristics and Financial and Operational Performance of Rural Health Clinics in the United States: A Chartbook
Chartbook
Maine Rural Health Research Center
Date: 05/2022
This chartbook provides an overview of Rural Health Clinic (RHC) characteristics and issues and will be useful to policymakers and others interested in the performance of RHCs nationally. It provides a discussion of the challenges related to collection and reporting of RHC quality data.
Prehospital Emergency Medical Services Personnel: Comparing Rural and Urban Professional Experience and Provision of Evidence-Based Care
Policy Brief
WWAMI Rural Health Research Center
Date: 05/2022
This policy brief examines the effects of emergency medical services (EMS) personnel level of experience and agency rurality on the provision of evidenced-based care. Compared with urban-serving EMS agencies, rural-serving agencies provided evidence-based care less often for stroke, hypoglycemia, and trauma but more often for seizures.
Racial/Ethnic Differences in Adverse and Positive Childhood Experiences Across Rural Communities: Results From the National Survey of Children's Health
Policy Brief
Rural and Minority Health Research Center
Date: 05/2022
This study examined whether ACE and PCE exposure varied by race/ethnicity, among rural children, finding that there were higher rates of four or more ACEs among racial/ethnic minority children.
Medicare Accountable Care Organization Characteristics Associated With Participation in 2‐Sided Risk
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 05/2022
This study examined the associations of accountable care organization (ACO) characteristics with the likelihood of participation in 2-sided risk tracks in the Medicare Shared Savings Program. Small and rural ACOs were found to be less prepared to transition into 2-sided risk tracks than their urban counterparts.
Comparison of Cancer Treatment Services Across Hospitals
Fact Sheet
Rural and Minority Health Research Center
Date: 05/2022
This research compared the availability of comprehensive oncology, chemotherapy, and radiation therapy in Critical Access Hospitals and non-Critical Access Hospitals.
The Northern Border Region: A Health-Focused Landscape Analysis
Chartbook
Maine Rural Health Research Center
Date: 04/2022
These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
Vermont: A Health-Focused Landscape Analysis
Chartbook
Maine Rural Health Research Center
Date: 04/2022
These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
New York: A Health-Focused Landscape Analysis
Chartbook
Maine Rural Health Research Center
Date: 04/2022
These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
New Hampshire: A Health-Focused Landscape Analysis
Chartbook
Maine Rural Health Research Center
Date: 04/2022
These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
Maine: A Health-Focused Landscape Analysis
Chartbook
Maine Rural Health Research Center
Date: 04/2022
These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
Predictors of Hospital Choice Among Rural Patients Seeking Elective Surgery: A Scoping Review
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 04/2022
The purpose of this scoping review was to identify literature describing determinants of hospital choice among rural patients seeking elective surgery.
Rates and Trends of Childhood Overweight/Obesity in the United States and South Carolina
Fact Sheet
Rural and Minority Health Research Center
Date: 03/2022
The goal of this project was to estimate childhood overweight/obesity rates across the United States at the region, state, and county level.
Rural Hospital Administrators' Beliefs About Safety, Financial Viability, and Community Need for Offering Obstetric Care
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2022
This study offers results from a national survey of a sample of 292 rural hospitals that provided obstetric services in 2021. Obstetric unit administrators shared about their experiences, the challenges they face, and the decisions that factor into providing labor and birth care for their rural communities.
Rural Hospital Profitability During the Global COVID-19 Pandemic Requires Careful Interpretation
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 03/2022
Many small rural hospitals struggle with profitability compared to their urban counterparts. The findings brief describes the pre-pandemic (2011-19) trend of rural hospital profitability and explains why possible increases in reported profitability during the pandemic (2020-21) may mask the long-term financial challenges of rural hospitals.
The Economic Effects of Rural Hospital Closures
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 03/2022
This study updates previous research (Holmes, et al. 2006) on the economic effects of rural hospital closures by measuring the economic changes over time among U.S. rural counties that had a hospital closure from 2001-2018.
Since 1990, Rural Hospital Closures Have Increasingly Occurred in Counties That Are More Urbanized, Diverse, and Economically Unequal
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center
Date: 03/2022
The brief describes the socio‐economic, demographic, and health system characteristics for rural counties with and without hospital closures between 1990 and 2020. We analyzed potential differences among counties that experienced rural hospital closures from 2010‐2020 compared to counties with rural hospital closures from 1990‐2009.
Disparities in Prenatal Immunization Rates in Rural and Urban U.S. Areas by Indicators of Access to Care
Journal Article
Southwest Rural Health Research Center
Date: 02/2022
This study evaluates variations in immunization rates among pregnant women across the urban-rural continuum. Results indicate pregnant women in rural areas more commonly rely on Medicaid to fund prenatal care but are less likely to have full or expanded access to Medicaid. This finding may contribute to immunization uptake disparities.
Estimating Mortality From Coal Workers' Pneumoconiosis Among Medicare Beneficiaries With Pneumoconiosis Using Binary Regressions for Spatially Sparse Data
Journal Article
Rural and Underserved Health Research Center
Date: 02/2022
This study estimates mortality from coal workers' pneumoconiosis and other pneumoconioses among Medicare beneficiaries using the 5% Medicare Limited Claims Data Set, 2011-2014.
Contact by Collection Agencies for Medical Debt: Rural-Urban Differences Among Older and Younger Medicare Beneficiaries
Journal Article
University of Minnesota Rural Health Research Center
Date: 02/2022
This study uses data from the 2016 Medicare Current Beneficiary Survey (n = 12,688 U.S. community-dwelling beneficiaries) to understand the impact of medical debt for rural residents. The study analyzed rural-urban differences in rates of collection agency contact for unpaid medical bills.
The Problem of the Color Line: Place, Race, and Access to Health Care in America
Journal Article
Rural and Minority Health Research Center
Date: 02/2022
Using ZIP Code Tabulation Area boundaries and associated rural-urban commuting area codes, urban and rural places with the largest share of minoritized racial and ethnic groups were identified. A StoryMap was then created to illustrate disparities experienced based on where Indigenous populations and people of color reside spatially.
Quality of Home Health Agencies Serving Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2022
This policy brief describes the quality of home health agencies (HHAs) by rural-serving status. While quality of patient care star ratings were not associated with rural-serving status, rural HHAs and urban HHAs that serve rural patients had higher patient experience star ratings than urban HHAs that do not serve rural patients.
Quality of Skilled Nursing Facilities Serving Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2022
This policy brief describes the quality of skilled nursing facilities (SNFs) by rural-serving status. While overall star ratings and staffing star ratings were not associated with rural-serving status, rural SNFs and urban SNFs that serve rural patients had lower quality star ratings compared to urban SNFs that do not serve rural patients.
Perceptions and Practices for Colorectal and Cervical Cancer Prevention and Control in Rural Health Clinics in South Carolina
Fact Sheet
Rural and Minority Health Research Center
Date: 02/2022
This study investigated the perceptions and practices for colorectal and cervical cancer prevention and control in Rural Health Clinics in South Carolina. Health practitioner interviews were used to gather qualitative data.
Colorectal and Cervical Cancer Prevention in Rural Health Clinics in South Carolina
Fact Sheet
Rural and Minority Health Research Center
Date: 02/2022
This study investigated the perceptions and practices of cervical and colorectal cancer prevention in Rural Health Clinics. An online survey was administered to all Rural Health Clinics in South Carolina. Quantitative survey findings and key takeaways were reported.
Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress
Policy Brief
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 02/2022
Economic fluctuations and periods of distress in farming cannot be eliminated, however, their impact on communities and individuals can be mitigated. Strategies for meeting the behavioral health needs of farm families by supporting community-based services, and expanding behavioral health services in rural contexts are highlighted in this work.
Serious Mental Illness and Mental Health Treatment Utilization Among Adults Residing in Non-Metropolitan and Metropolitan Counties
Policy Brief
Rural and Underserved Health Research Center
Date: 02/2022
This report estimates and compares the prevalence of mental health treatment utilization and reasons for not seeking mental health treatment among adults with serious mental illness residing in non-metropolitan and metropolitan counties nationally.
Rural-Urban Differences in Adverse and Positive Childhood Experiences: Results From the National Survey of Children's Health
Policy Brief
Rural and Minority Health Research Center
Date: 01/2022
This brief examines the types and counts of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) for rural and urban children. The study reports on the differences between rural and urban ACEs and PCEs across all fifty states and the District of Columbia.
Social Cohesion and Social Engagement Among Older Adults Aging in Place: Rural/Urban Differences
Policy Brief
University of Minnesota Rural Health Research Center
Date: 01/2022
This policy brief examines rural/urban differences in social cohesion and social engagement for older adults aging in place, as well as within-rural differences by race and ethnicity.
Evaluating the Rural HIV/AIDS Planning Program
Policy Brief
University of Minnesota Rural Health Research Center
Date: 01/2022
The purpose of this policy brief is to understand the overall experiences of the first grantee cohort (2020-21) of the Rural HIV/AIDS Planning Program. We pay particular attention to any barriers to or facilitators of successful grant implementation, and the sustainability of programs and acquisition of future funding.
High-Performing Rural Health System
Policy Brief
RUPRI Health Panel: Rural Policy Analysis and Applications
Date: 01/2022
This document updates the RUPRI Health Panel's framework, for a high-performing rural health system, originally published in 2011. It offers a revised vision statement and updates the high-performing rural health system pillars (access, affordability, community health, and quality) and describes an underlying base of equity considerations.
An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status
University of Minnesota Rural Health Research Center
Date: 01/2022
The purpose of this methodology brief is to describe an enhanced method for identifying hospital-based obstetric unit status and for identifying closures of obstetric units.
Rural Hospitals That Closed Between 2017‐20: Profitability and Liquidity in the Year Before Closure
Policy Brief
North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
Date: 01/2022
This brief examines the preclosure profitability and liquidity performance of rural hospitals that closed between 2017‐20 and compare it to the median performance of rural hospitals that remained open during the same year.