Diabetes: Rural Health Research Products & Journal Articles

2024

Rural-Urban Differences in Self-Reported Participation in Diabetes Self-Management Education
Journal Article
Rural and Minority Health Research Center
Date: 09/2024
Using 2019 Behavioral Risk Factor Surveillance System data, this study examined the proportion of rural versus urban adults who reported receiving Diabetes Self-Management Education.
Prevent or Treat: Availability of Diabetes Self-Management Education and Dialysis in High Need Rural Counties
Policy Brief
Rural and Minority Health Research Center
Date: 03/2024
In this brief, researchers assess the availability of in-county diabetes self-management education and dialysis across rural and urban counties.
Availability and Quality of Dialysis Care in Rural Versus Urban U.S. Counties
Journal Article
Rural and Minority Health Research Center
Date: 02/2024
An examination of rural-urban differences in quality of dialysis care offered across the United States was conducted using data from Medicare certified dialysis facilities in 2020 from the Centers for Medicaid and Medicare.

2023

Diabetes Prevalence and Monitoring in Nonmetropolitan and Metropolitan Areas Within a Commercially Insured U.S. Population
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2023
This study used recent claims data, from services received between 2018 and 2020, to examine the prevalence of diabetes and to determine if patients with diabetes are more or less likely to receive annual hemoglobin A1c screening.
Rural Healthy People 2030: Common Challenges, Rural Nuances
Policy Brief
Southwest Rural Health Research Center
Date: 05/2023
This study analyzes the most important Healthy People 2030 priorities for rural America. Data collected from a survey found mental health, substance use, health care access, and economic stability were among the most important priorities. This information could be used to accelerate health improvements in rural America.

2021

Racial, Rural, and Regional Disparities in Diabetes-Related Lower-Extremity Amputation Rates, 2009–2017
Journal Article
Southwest Rural Health Research Center
Date: 09/2021
This study examines race, rurality, and regional disparities in diabetes-related lower-extremity amputations (LEA) among adult hospitalizations from 2009-2017. Findings indicate rising minor LEA rates among Asians/Pacific Islanders and rising major LEA rates among hospitalized diabetes patients in the Midwest.
Cardiovascular & Cancer Rates for the Rural Delta Region: Rural Delta Region Map Tool
North Carolina Rural Health Research and Policy Analysis Center
Date: 08/2021
The Rural Delta Region Map Tool is an interactive tool that shows 13 health measures for people in Delta Region counties/parishes. It can be used to compare rates of cancer and cardiovascular disease by county, by rural-urban status, to peer counties, to the national average, and to national quartiles.

2020

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 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 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.

2019

The Changing Landscape of Diabetes Mortality in the United States Across Region and Rurality, 1999-2016
Journal Article
Southwest Rural Health Research Center
Date: 02/2019
This brief report examines place-based differences in diabetes mortality to understand whether disparities in diabetes mortality have changed across U.S. Census regions and levels of rurality over time. Reductions in diabetes mortality are lagging in rural areas, and the rural South in particular, relative to other areas of the country.
Diabetes-Related Hospital Mortality in the U.S.: A Pooled Cross-Sectional Study of the National Inpatient Sample
Journal Article
Southwest Rural Health Research Center
Date: 02/2019
This study examined place-based and individual-level variations in diabetes-related hospital deaths using the 2009-2015 National Inpatient Sample. Results show that place-based disparities exist. Targeted focus should be placed on the control of diabetic complications in the South, West, and Midwest census regions and among rural residents.

2018

Diabetes-Related Hospital Mortality in Rural America: A Significant Cause for Concern
Policy Brief
Southwest Rural Health Research Center
Date: 03/2018
This brief is the third in a series prepared by the Southwest Rural Health Research Center on the topic of diabetes. The aim of this study was to examine trends and rates of diabetes-related deaths for persons hospitalized in the U.S., with emphasis on differences across the urban-rural continuum and across census regions.

2017

Diabetes and Forgone Medical Care Due to Cost in the U.S. (2011-2015): Individual-level and Place-Based Disparities
Policy Brief
Southwest Rural Health Research Center
Date: 08/2017
This brief is the first in a series prepared by the Southwest Rural Health Research Center on the topic of diabetes. The two aims of this study were to identify trends in diabetes rates and forgone medical care among persons with diabetes in the U.S. and to identify geographic determinants and other social determinants of health disparities.
Diabetes Mortality in Rural America: 1999-2015
Policy Brief
Southwest Rural Health Research Center
Date: 08/2017
This brief is the second in a series prepared by the Southwest Rural Health Research Center on the topic of diabetes. The primary aim of this study was to understand the scope of diabetes-related mortality in urban and rural America. We analyzed mortality caused by diabetes over a 16-year period and explored the roles played by rurality and race.
Assessing Diabetes and Factors Associated With Foregoing Medical Care Among Persons With Diabetes: Disparities Facing American Indian/Alaska Native, Black, Hispanic, Low Income, and Southern Adults in the U.S. (2011-2015)
Journal Article
Southwest Rural Health Research Center
Date: 04/2017
The purpose of this project was to identify individual- and place-based factors associated with diagnosed diabetes and foregone medical care among those diagnosed with diabetes. Diabetes prevalence and foregone medical care were found to be higher for those with lower incomes, for several racial/ethnic groups, and in the South versus other regions.

2016

Pilot Testing a Rural Health Clinic Quality Measurement Reporting System
Policy Brief
Maine Rural Health Research Center
Date: 02/2016
More than 4,000 Rural Health Clinics (RHCs) serve the primary care needs of rural communities. Unfortunately, the Rural Health Clinic Program is plagued by a lack of data participating clinics. This reports on the results with a focus on assessing the feasibility and utility of the reporting system and quality measures for the participating RHCs.

2014

Intensity of Service Provision for Medicare Beneficiaries Utilizing Home Health Services: A Closer Look at Cerebrovascular Disease, Diabetes, and Joint Replacement
Report
Rural and Minority Health Research Center
Date: 11/2014
This report details the impact of home health services provided to the rural elderly receiving Medicare by the number of visits, the use of rehabilitation specialists, and the median payment per each claim.
Implications of Rurality and Psychiatric Status for Diabetic Preventive Care Use Among Adults With Diabetes
Policy Brief
Maine Rural Health Research Center
Date: 05/2014
This brief examines patterns of diabetic preventive care use among adults with diabetes to determine whether these patterns vary according to respondents' rural/urban residence or the presence/absence of a mental health diagnosis.

2012

Lower Rehospitalization Rates Among Rural Medicare Beneficiaries With Diabetes
Journal Article
Rural and Minority Health Research Center
Date: 2012
Evaluates 30-day readmission rates of Medicare beneficiaries with diabetes in rural areas.
Missing the Handoff: Post-Hospitalization Follow-up Care Among Rural Medicare Beneficiaries With Diabetes
Journal Article
Rural and Minority Health Research Center
Date: 2012
Analyzes urban and rural differences in post-discharge physician follow-up care using data from 2005 Medicare claims files.

2011

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.
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.

2008

Health Disparities: A Rural-Urban Chartbook (Fact Sheet)
Rural and Minority Health Research Center
Date: 12/2008
This fact sheet expands the work of the National Healthcare Disparities Reports, issued annually by the Agency for Healthcare Research and Quality, by examining potential disparities among rural populations in health, health behaviors, preventive services, and diabetes care.
Health Disparities: A Rural-Urban Chartbook (Full Report)
Rural and Minority Health Research Center
Date: 06/2008
This chartbook expands the work of the National Healthcare Disparities Reports, issued annually by the Agency for Healthcare Research and Quality, by examining potential disparities among rural populations in health, health behaviors, preventive services, and diabetes care.

2007

Ambulatory Care Sensitive Condition Hospitalizations Among Rural Children (Brief)
Upper Midwest Rural Health Research Center
Date: 06/2007
This brief reports results from a study examining children's inpatient hospitalizations for ambulatory care sensitive conditions, rural residence, poverty, health insurance, and physician supply. Admission rates were examined for asthma, diabetes short-term complications, gastroenteritis, urinary tract infection, and perforated appendix.

2006

Elements of Successful Rural Diabetes Management Programs
RUPRI Center for Rural Health Policy Analysis
Date: 07/2006
This report shares findings from a study about local innovations implemented by rural chronic disease management programs. Using diabetes as a proxy for all chronic diseases, the authors explored how local innovations overcame challenges of the rural setting to provide effective and efficient disease management.
Chronic Disease Management Systems (Registries) in Rural Health Care
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 05/2006
A Chronic Disease Management System (CDMS) is a tool that helps providers collect and analyze patient information to promote quality care. This study shows that CDMSs are readily available to rural clinics and are being implemented and maintained by clinic staff with minimal expenditures for technology.
Rural Residence and Hispanic Ethnicity: Doubly Disadvantaged for Diabetes?
Journal Article
Rural and Minority Health Research Center
Date: 2006
Determines whether living in a rural area and being Hispanic confers special risks for diagnosis and control of diabetes.

2005

Rural Diabetes Care Management Programs: An Inventory of Sample Programs in Six States
RUPRI Center for Rural Health Policy Analysis
Date: 12/2005
This report was developed to share key contact and program information with organizations that are interested in starting a chronic disease management program in their facility.
Barriers Associated With the Delivery of Medicare Reimbursed Diabetes Self-Management Education
Journal Article
Rural and Minority Health Research Center
Date: 11/2005
Explores the barriers that practitioners face in providing diabetes self-management education to Medicare beneficiaries. Barriers identified for rural providers include costs, the shortage of designated specialists, fewer resources, amount of Medicare reimbursement, transportation and more.

2004

Assessment of Barriers to the Delivery of Medicare Reimbursed Diabetes Self-Management Education in Rural Areas
Rural and Minority Health Research Center
Date: 09/2004
This report explores the barriers that rural practitioners face in providing diabetes education services to Medicare beneficiaries.
Barriers to the Delivery of Medicare Reimbursed Diabetes Self-Management Education in Rural Areas
Fact Sheet
Rural and Minority Health Research Center
Date: 2004
Diabetes Self-Management Education programs help newly diagnosed and chronic patients with diabetes learn to manage their care. This project explored the barriers that rural practitioners face in providing diabetes education to Medicare beneficiaries.
Diabetes & Hypertension Among Rural Hispanics
Fact Sheet
Rural and Minority Health Research Center
Date: 2004
This fact sheet describes rates of diabetes and hypertension among rural Hispanics.
Diabetes & Hypertension Among Rural Hispanics: Disparities in Diagnostics and Disease Management
Rural and Minority Health Research Center
Date: 2004
Modest health disparities were found among rural Hispanics when examining diabetes. Undiagnosed hypertension was higher for rural residents than for urban residents. A large proportion of persons diagnosed with either disease had poor control of their condition, as indicated by elevated glucose levels or high blood pressure.

2003

Chronic Disease Management in Rural and Underserved Areas: Patient Responses and Outcomes
Southwest Rural Health Research Center
Date: 11/2003
Findings from site visits and interviews with six chronic disease management (DM) programs across the United States indicated DM programs were extremely important in the areas of patient healthcare and quality of care and resulted in positive clinical and financial outcomes.
Hospitalization for Ambulatory Care Sensitive Conditions: Asthma, Diabetes, and Congestive Heart Failure in South Carolina
Rural and Minority Health Research Center
Date: 05/2003
Hospitalization rates for ambulatory care sensitive conditions, diseases for which primary care in the preceding six months could have reduced or eliminated the need for hospitalization, are a commonly used indicator of disparities in access to care.
Diabetes and Cardiovascular Disease Among Rural African Americans
Rural and Minority Health Research Center
Date: 02/2003
This report investigates the association of race and rural residence on rates of diagnosis of diabetes and cardiovascular disease and indicators of good medical control among people with diabetes, hypertension, and cardiovascular disease.
Diabetes and Cardiovascular Disease in Rural African Americans
Fact Sheet
Rural and Minority Health Research Center
Date: 2003
Previous research has indicated that persons living in rural areas are more vulnerable to poor health than those living in urban areas. Minorities in particular are more vulnerable to poor health than non-minorities.
Hospitalization for Ambulatory Care Sensitive Conditions: Congestive Heart Failure, Diabetes and Asthma in South Carolina
Fact Sheet
Rural and Minority Health Research Center
Date: 2003
This fact sheet gives a brief overview of findings from a study of hospitalizations in South Carolina for ambulatory care sensitive conditions.
Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 1
Southwest Rural Health Research Center
Date: 2003
This report offers brief overviews of the top rural health concerns and objectives associated with Healthy People 2010 focus areas. Also included are references to key literature about these concerns and descriptions of models for practice that rural communities can draw upon to achieve key Healthy People 2010 objectives.

2002

Hypertension, Diabetes, Cholesterol, Weight, and Weight Control Activities Among Non-Metro Minority Adults
Rural and Minority Health Research Center
Date: 12/2002
This report uses data from the 1998 National Health Interview Survey to examine the prevalence of selected problems among rural populations, with an emphasis on rural minorities.
Diabetes and the Rural Safety Net
Maine Rural Health Research Center
Date: 01/2002
This paper investigates the extent to which the rural safety net is able to meet the needs of people with diabetes.

2001

Improving the Quality of Outpatient Care for Older Patients With Diabetes: Lessons From a Comparison of Rural and Urban Communities
Journal Article
WWAMI Rural Health Research Center
Date: 08/2001
Compares the quality of diabetic care received by patients in rural and urban communities in Washington State. Concludes that large rural towns may provide the best conditions for high-quality care-growing communities that serve as regional referral centers and have an adequate, but not excessive, supply of generalist and specialist physicians.

2000

Race and Place: Urban-Rural Differences in Health for Racial and Ethnic Minorities
North Carolina Rural Health Research and Policy Analysis Center
Date: 03/2000
This findings brief investigates urban-rural disparities for racial and ethnic minorities in six health areas: infant mortality, cancer screening and management, cardiovascular disease, diabetes, HIV infection, and child and adult immunizations.

1999

Rural and Urban Physicians: Does the Content of Their Medicare Practices Differ?
Journal Article
WWAMI Rural Health Research Center
Date: 1999
Rural and urban areas have significant differences in the availability of medical technology, medical practice structures and patient populations. This study uses 1994 Medicare claims data to examine whether these differences are associated with variation in the content of practice between physicians practicing in rural and urban areas.