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Elizabeth Crouch, PhD

Co-Director, University of South Carolina Rural Health Research Center

Phone: 803.576.6055
Email: crouchel@mailbox.sc.edu

Health Services Policy and Management
University of South Carolina


Current Projects - (8)

  • Changes in Medicare Fee-for-Services Health Care Expenditures in Rural and Urban Communities after Passage of the Affordable Care Act
    This project will assess changes in Medicare per-beneficiary spending across rural and urban counties from 2007 to 2020. It will examine differences in rural versus urban per-beneficiary spending on hospital inpatient, hospital outpatient, physician, and post-acute care after the Affordable Care Act (ACA).
    Research center: University of South Carolina Rural Health Research Center
    Topics: Care management, Chronic diseases and conditions, Health services, Hospitals and clinics, Public health
  • Identifying High-Need Counties for Resource Planning
    The primary aim of this project is to use data examining health care infrastructure, chronic disease prevalence, and the socioeconomic environment to create a metric for classifying rural counties based on needs and resources.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Healthcare access, Maternal health, Obesity, Oral health, Physicians, Poverty, Public health, Rural statistics and demographics, Social determinants of health, Uninsured and underinsured, Workforce
  • Oral Healthcare Utilization and Outcomes of Rural and Urban Medicaid-Insured Children in the United States
    Using nationally representative Medicaid claims data, this project will determine rural-urban differences in the prevalence of early childhood caries, preventative dental visits, and restorative dental visits.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Children and adolescents, Medicaid and CHIP, Oral health, Rural statistics and demographics
  • Rural-Urban Differences in Addressable Drivers of Staff Turnover in Skilled Nursing Facilities
    The aim of the proposed study is to assess facility-level turnover rates for total nursing and registered nursing personnel across levels of rurality and by region looking at factors such as staffing ratios that can be managed by facility administrators.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Health services, Hospitals and clinics, Nurses and nurse practitioners, Public health, Rural Health Clinics (RHCs), Workforce
  • Rural-Urban Differences in Emergency Department Utilization and Costs for Dental Conditions
    Emergency Department (ED) Utilization is a de facto provider for untreated dental issues. Understanding rural-urban differences in ED use for dental conditions in recent years is essential to inform federal, state, and community-level dental health initiatives such as preventive dental care, tele-dentistry infrastructure expansion, and oral hygiene practices. Ongoing national efforts addressing rural disparities in dental care should target individuals most at risk for missing preventive care and utilizing the ED for dental care.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Oral health
  • Spatial Distribution of Pre-Exposure Prophylaxis (PrEP) Need and Care
    The incidence of HIV is disproportionately high in rural areas, but these communities often lack access to evidence-based interventions to prevent new HIV diagnoses such as PrEP. Using Medicaid claims data and the Centers for Medicare & Medicaid Services Provider file, this study will determine geographic disparities (by rurality and region) in the need for PrEP and PrEP availability and identify whether PrEP availability meets the needs across geography.
    Research center: University of South Carolina Rural Health Research Center
    Topic: Pharmacy and prescription drugs
  • State-Level Medicaid Bundled Payments and Rural Perinatal Care
    The impacts of state-level Medicaid bundled payment models will depend on many factors, such as maternity care facility structure, scope of services, and local patient bypassing behaviors during prenatal, intrapartum, and postpartum periods. For rural providers who often offer prenatal and postpartum care but not labor and delivery services, these bundled payments may impose additional financial and logistical challenges.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Maternal health, Medicaid and CHIP
  • The Rural Landscape of Diabetes in the United States
    Rural-urban differences in diabetes and diabetes management may be attributed to socioeconomic differences and treatment available to rural residents. Using data from 2021-2023 National Health Interview Survey, this study will examine 1) rural-urban differences in diabetes and prediabetes incidence and prevalences, 2) rural-urban differences in the management, treatment, and complications associated with diabetes, and co-occurring risk factors for cardiovascular disease.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Diabetes, Healthcare access, Rural statistics and demographics

Completed Projects - (4)


Publications - (16)

2024

2023

2022

2021

2020

  • A National Survey of RN-to-BSN Programs: Are They Reaching Rural Students?
    Journal Article
    University of South Carolina Rural 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.
  • Factors Associated With Perceived Job Preparedness Among RNs: Results From a National Survey
    Journal Article
    University of South Carolina Rural 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.
  • Rural-Urban Differences in Educational Attainment Among Registered Nurses: Implications for Achieving an 80% BSN Workforce
    Journal Article
    University of South Carolina Rural 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.

2019

2018

2017