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Journal of Rural Health

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https://www.readbyqxmd.com/read/29737573/organizational-attributes-associated-with-medicare-aco-quality-performance
#1
Xi Zhu, Keith Mueller, Huang Huang, Fred Ullrich, Thomas Vaughn, A Clinton MacKinney
PURPOSE: To evaluate associations between geographic, structural, and service-provision attributes of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) and the ACOs' quality performance. METHODOLOGY: We conducted cross-sectional and longitudinal analyses of ACO quality performance using data from the Centers for Medicare and Medicaid Services and additional sources. The sample included 322 and 385 MSSP ACOs that had successfully reported quality measures in 2014 and 2015, respectively...
May 8, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29696696/engaging-stakeholders-in-the-development-of-an-ehealth-intervention-for-cancer-symptom-management-for-rural-residents
#2
Stephanie Gilbertson-White, Chi W Yeung, Seyedehtanaz Saeidzadeh, Hannah Tykol, Praveen Vikas, Ashley Cannon
BACKGROUND: Late-stage cancer diagnoses disproportionately occur in rural residents, frequently resulting in increased need for symptom management support with minimal access to these services. Oncology Associated Symptoms and Individualized Strategies (OASIS) is an eHealth symptom self-management intervention that was developed to provide cancer symptom self-management support and address this disparity. PURPOSE: To engage stakeholders about the symptom management needs and concerns of patients with advanced cancer living in rural areas...
April 25, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29696686/confidence-in-measurement
#3
LETTER
Jennifer Kowalkowski
No abstract text is available yet for this article.
April 25, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29664203/trends-and-patterns-of-opioid-analgesic-prescribing-regional-and-rural-urban-variations-in-kentucky-from-2012-to-2015
#4
Huong Luu, Svetla Slavova, Patricia R Freeman, Michelle Lofwall, Steven Browning, Heather Bush
PURPOSE: Increased opioid analgesic prescribing (OAP) has been associated with increased risk of prescription opioid diversion, misuse, and abuse. We studied regional and rural-urban variations in OAP trends in Kentucky, from 2012 to 2015, and examined potential county-level risk and protective factors. METHODS: This study used prescription drug monitoring data. Marginal models employing generalized estimating equations were used to model repeated counts of residents with opioid analgesic prescriptions within county-quarter, 2012-2015, with offset for resident population, by rural-urban classification exposure, and adjusting for time-varying socioeconomic and relevant health status measures...
April 17, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29664202/training-psychologists-for-rural-practice-exploring-opportunities-and-constraints
#5
Marisa Elena Domino, Ching-Ching Claire Lin, Joseph P Morrissey, Alan R Ellis, Erin Fraher, Erica L Richman, Kathleen C Thomas, Mitchell J Prinstein
PURPOSE: To examine trends in the psychologist workforce and training opportunities, including factors that may influence the decision of clinical psychologists to practice in rural settings. METHODS: We use a mixed-methods approach to examine the psychologist workforce nationally and in North Carolina (NC), including (1) an analysis of the location of programs awarding doctoral degrees; (2) an analysis of the practice, demographic, and educational characteristics of the psychologist workforce; and (3) interviews with directors of doctoral programs in clinical psychology to understand where current graduates are getting jobs and why they may or may not be choosing to practice in rural communities...
April 17, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29656565/rural-urban-differences-in-costs-of-end-of-life-care-for-the-last-6-months-of-life-among-patients-with-breast-lung-or-colorectal-cancer
#6
Elizabeth Crouch, Jan M Eberth, Janice C Probst, Kevin Bennett, Swann A Adams
PURPOSE: The purpose of this study was to examine rural-urban differences in utilization and expenditures in the last 6 months of life for patients with breast, lung, or colorectal cancer. METHODS: The study used a 5% sample of the 2013 Medicare Research Identifiable Files to study utilization and expenditures for beneficiaries with breast, lung, or colorectal cancer during the last 6 months before death (n = 6,214). End of life expenditures were calculated as the sum of total Medicare expenditures for inpatient, outpatient, physician, home health, hospice, and skilled nursing facility costs during the last 6 months of life...
April 15, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29656463/rural-health-networks-how-network-analysis-can-inform-patient-care-and-organizational-collaboration-in-a-rural-breast-cancer-screening-network
#7
Beth Prusaczyk, Julia Maki, Douglas A Luke, Rebecca Lobb
PURPOSE: Rural health networks have the potential to improve health care quality and access. Despite this, the use of network analysis to study rural health networks is limited. The purpose of this study was to use network analysis to understand how a network of rural breast cancer care providers deliver services and to demonstrate the value of this methodology in this research area. METHODS: Leaders at 47 Federally Qualified Health Centers and Rural Health Clinics across 10 adjacent rural counties were asked where they refer patients for mammograms or breast biopsies...
April 15, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29297608/portraying-a-more-complete-picture-of-illicit-drug-use-epidemiology-and-policy-for-rural-america-a-competing-viewpoint-to-the-cdc-s-mmwr-report
#8
Tyrone F Borders
No abstract text is available yet for this article.
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/28872697/perceived-barriers-and-facilitators-to-providing-methadone-maintenance-treatment-among-rural-community-pharmacists-in-southwestern-ontario
#9
Joseph Fonseca, Andrew Chang, Feng Chang
PURPOSE: Misuse of opioids has become a public health concern across North America. Rural patients have limited access to methadone maintenance treatment (MMT), an opioid addiction-treatment service that could be offered by community pharmacists. The aim of this study was to identify rural community pharmacists' perceived barriers, motivations, and solutions to offering MMT to their patients. METHODS: One-on-one, semistructured interviews were conducted with 11 community pharmacists who practice in rural southwestern Ontario...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/28842930/medication-assisted-opioid-treatment-prescribers-in-federally-qualified-health-centers-capacity-lags-in-rural-areas
#10
Emily B Jones
PURPOSE: This study explores correlates of on-site availability of substance use disorder treatment services in federally qualified health centers, including buprenorphine treatment that is critical to addressing the opioid epidemic. METHODS: We employed descriptive and multivariable analyses with weighted 2010 Assessment of Behavioral Health Services survey data and the 2010 Uniform Data System. FINDINGS: In 2010, 47.6% of health centers provided on-site substance use disorder treatment, 12...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/28685885/mental-health-and-substance-use-care-among-young-adults-before-and-after-affordable-care-act-aca-implementation-a-rural-and-urban-comparison
#11
Laura J Chavez, Kelly J Kelleher, Steven C Matson, Thomas M Wickizer, Deena J Chisolm
PURPOSE: Rural young adults experience greater unmet need for mental health (MH) and alcohol or drug (AOD) treatment and lower health insurance coverage than urban residents. It is unknown whether Affordable Care Act (ACA) reforms in 2010 (dependent coverage extended to age 26) or 2014 (Medicaid expansion) closed rural/urban gaps in insurance and treatment. The present study compared changes in rates of health insurance, MH treatment, and AOD treatment for rural and urban young adults over a period of ACA reforms...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/28685884/correlates-of-injection-drug-use-among-rural-appalachian-women
#12
Michele Staton, Gabriele Ciciurkaite, Jennifer Havens, Martha Tillson, Carl Leukefeld, Matthew Webster, Carrie Oser, Bridgette Peteet
BACKGROUND: Limited research has focused on correlates of injection drug use (IDU) among high-risk subgroups of drug users, particularly women, who may be at increased risk for transmission of infectious diseases such as HIV and Hepatitis C. The purpose of this study is to better understand the contextual and health correlates of IDU among women living in rural Appalachia by examining (1) differences between injectors and noninjectors, and (2) the unique correlates of recent IDU and past IDU...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/28685864/rural-and-appalachian-disparities-in-neonatal-abstinence-syndrome-incidence-and-access-to-opioid-abuse-treatment
#13
Joshua D Brown, Amie J Goodin, Jeffery C Talbert
OBJECTIVE: Incidence of neonatal abstinence syndrome (NAS) is increasing due to the rise in opioid use. Rural states like Kentucky have been disproportionally impacted by opioid abuse, and this study determines NAS burden nationally and in Kentucky while quantifying differences in access to care between Appalachian and non-Appalachian counties. METHODS: NAS rates were calculated using National (2013) and Kentucky (2008-2014) National Inpatient Sample discharge data...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/28295611/variation-in-networks-and-forms-of-support-for-care-seeking-across-the-hiv-care-continuum-in-the-rural-southeastern-united-states
#14
Miranda Hill, Amber Huff, Neale Chumbler
PURPOSE: In spite of progress in understanding the importance of social support for health outcomes in Persons Living with HIV (PLWH), more remains to be known about mechanisms of support most beneficial at each stage of HIV treatment. In this study, we use a qualitative analytic approach to investigate the forms and sources of social support deemed most integral to the diagnosis, care engagement, and medication adherence behaviors of a diverse sample of PLWH in a mostly rural health district in the Southeastern United States...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/28084667/task-sharing-approaches-to-improve-mental-health-care-in-rural-and-other-low-resource-settings-a-systematic-review
#15
Theresa J Hoeft, John C Fortney, Vikram Patel, Jürgen Unützer
PURPOSE: Rural areas persistently face a shortage of mental health specialists. Task shifting, or task sharing, is an approach in global mental health that may help address unmet mental health needs in rural and other low-resource areas. This review focuses on task-shifting approaches and highlights future directions for research in this area. METHODS: Systematic review on task sharing of mental health care in rural areas of high-income countries included: (1) PubMed, (2) gray literature for innovations not yet published in peer-reviewed journals, and (3) outreach to experts for additional articles...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/28045193/support-and-sabotage-a-qualitative-study-of-social-influences-on-health-behaviors-among-rural-adults
#16
Urshila Sriram, Emily H Morgan, Meredith L Graham, Sara C Folta, Rebecca A Seguin
PURPOSE: Social environments exert an important influence on health behaviors, yet evidence from rural-specific contexts is limited. This study explored how social relationships influence health-related behaviors among midlife and older rural adults at increased risk of chronic disease. METHODS: Seventeen focus groups were conducted with 125 sedentary, overweight/obese adults (aged 40-91 years) residing in "medically underserved" rural Montana towns in 2014...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/27620836/differences-in-selected-hiv-care-continuum-outcomes-among-people-residing-in-rural-urban-and-metropolitan-areas-28-us-jurisdictions
#17
John A Nelson, Anna Kinder, Anna Satcher Johnson, H Irene Hall, Xiaohong Hu, Donna Sweet, Alyssa Guido, Harold Katner, Jennifer Janelle, Maribel Gonzalez, Natalia Martínez Paz, Charlotte Ledonne, Jason Henry, Theresa Bramel, Jeanne Harris
PURPOSE: The HIV care continuum is used to monitor success in HIV diagnosis and treatment among persons living with HIV in the United States. Significant differences exist along the HIV care continuum between subpopulations of people living with HIV; however, differences that may exist between residents of rural and nonrural areas have not been reported. METHODS: We analyzed the Centers for Disease Control and Prevention's National HIV Surveillance System data on adults and adolescents (≥13 years) with HIV diagnosed in 28 jurisdictions with complete reporting of HIV-related lab results...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/27557414/financial-performance-of-rural-medicare-acos
#18
Matthew C Nattinger, Keith Mueller, Fred Ullrich, Xi Zhu
PURPOSE: The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence. METHODS: We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/27443961/differences-in-cigarette-use-and-the-tobacco-environment-among-youth-living-in-metropolitan-and-nonmetropolitan-areas
#19
Debra H Bernat, Kelvin Choi
PURPOSE: To examine cigarette use and the tobacco-related environment among adolescents living in metropolitan and nonmetropolitan areas. METHODS: Data from adolescents ages 14-17 that completed the 2012 Florida Youth Tobacco Survey were analyzed (n = 40,746). This includes a representative sample of middle and high school students throughout the state. RESULTS: Nonmetropolitan adolescents were more likely than metropolitan adolescents to report lifetime smoking, past 30-day smoking, daily smoking, initiating smoking at younger ages, having smoked a greater number of cigarettes in their lifetime and in the past 30 days, friend acceptance of adult smoking, a parent offering them a cigarette, living with a smoker, and that smoking was allowed in their home...
December 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/27380649/implementing-a-hospitalist-program-in-a-critical-access-hospital
#20
Brian M Dougan, Victor M Montori, Kurt W Carlson
PURPOSE: The hospitalist model of inpatient care has rapidly expanded, but little is known about hospitalist care in critical access hospitals (CAHs). We aimed to determine the impact of a hospitalist model of care on staff satisfaction, patient volumes, patient satisfaction, length of stay, and care quality in a CAH. METHODS: We initiated a hybrid rotating hospitalist program in September 2008 at Winneshiek Medical Center (Decorah, Iowa), a 25-bed rural CAH. We reviewed patient volumes, Centers for Medicare and Medicaid Services core quality measures, acute length of stay, and staff satisfaction for primary care-hospitalist physicians and inpatient and clinic nurses...
December 2018: Journal of Rural Health
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