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Journal of Rural Health

Rebecca Garr Whitaker, G Mark Holmes, George H Pink
PURPOSE: The low-volume hospital (LVH) payment adjustment established in the Patient Protection and Affordable Care Act (ACA) of 2010 is scheduled to sunset on October 1, 2017. The purpose of this analysis was: (1) to estimate the effect of the ACA LVH adjustment on qualifying hospitals' profitability margins; and (2) to examine hospital and market characteristics of the hospitals that would be most adversely affected by the loss of the ACA LVH adjustment. METHODS: 2004-2015 data from the Hospital Cost Report Information System, Hospital Market Service Area File and Nielsen-Claritas Pop-Facts file were used to estimate difference-in-difference regression models with hospital-level random effects in order to determine whether the ACA LVH adjustment improved qualifying rural hospitals' profitability margins...
November 16, 2016: Journal of Rural Health
Fady Ghali, Maria Celaya, Michael Laviolette, Johann Ingimarsson, Heather Carlos, Judy Rees, Elias Hyams
PURPOSE: We sought to determine whether further distance from a radiation center is associated with lower utilization of external beam radiation therapy (XRT). METHODS: We retrospectively identified patients with a new diagnosis of localized prostate cancer (CaP) within the New Hampshire State Cancer Registry from 2004 to 2011. Patients were categorized by age, D'Amico risk category, year of treatment, marital status, season of diagnosis, urban/rural residence, and driving time to the nearest radiation facility...
November 11, 2016: Journal of Rural Health
Jonathan M Loree, Khodadad R Javaheri, Shilo V Lefresne, Caroline H Speers, Jenny Y Ruan, Jennifer T Chang, Carl J Brown, Hagen F Kennecke, Robert A Olson, Winson Y Cheung
OBJECTIVES: Optimal treatment of rectal cancer (RC) requires multidisciplinary care. We examined whether distance to treatment center or community size impacts access to multimodality care and population-based outcomes in RC. METHODS: Patients diagnosed with stage II/III RC from 1999 to 2009 and treated at 1 of 6 regional cancer centers in British Columbia were reviewed. Distance to treatment center was determined for each patient. Communities were classified as rural, small, medium, and large population centers...
October 7, 2016: Journal of Rural Health
Judith Teich, Mir M Ali, Sean Lynch, Ryan Mutter
PURPOSE: There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas. METHODS: Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors...
October 4, 2016: Journal of Rural Health
Janice C Probst, Judith C Barker, Alexandra Enders, Paula Gardiner
PURPOSE: Children's health is influenced by the context in which they live. We provide a descriptive essay on the status of children in rural America to highlight features of the rural environment that may affect health. DESCRIPTION: We compiled information concerning components of the rural environment that may contribute to health outcomes. Areas addressed include the economic characteristics, provider availability, uniquely rural health risks, health services use, and health outcomes among rural children...
September 28, 2016: Journal of Rural Health
Paula A M Weigel, Fred Ullrich, Marcia M Ward
PURPOSE: Rural bypass for elective surgical procedures is a challenge for critical access hospitals, yet there are opportunities for rural hospitals to improve local retention of surgical candidates through alternative approaches to developing surgery lines of business. In this study we examine the effect of visiting surgical specialists on the odds of rural bypass. METHODS: Discharge data from the 2011 State Inpatient Databases and State Ambulatory Surgery Databases for Iowa were linked to outreach data from the Office of Statewide Clinical Education Programs and Iowa Physician Information System to model the effect of surgeon specialist supply on rural patients' decision to bypass rural critical access hospitals...
September 28, 2016: Journal of Rural Health
Richard A Crosby, Lindsay Stratdman, Tom Collins, Robin Vanderpool
PURPOSE: To determine the return rate of community-delivered fecal immunochemical test (FIT) kits in a rural population and to identify significant predictors of returning kits. METHODS: Residents were recruited in 8 rural Kentucky counties to enroll in the study and receive an FIT kit. Of 345 recruited, 82.0% returned an FIT kit from the point of distribution. These participants were compared to the remainder relative to age, sex, marital status, having an annual income below $15,000, not graduating from high school, not having a regular health care provider, not having health care coverage, being a current smoker, indicating current overweight or obese status, and a scale measure of fatalism pertaining to colorectal cancer...
September 21, 2016: Journal of Rural Health
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...
September 13, 2016: Journal of Rural Health
Katherine E Rebello, Jeffrey Gosian, Marci Salow, Pamela Sweeney, James L Rudolph, Jane A Driver
PURPOSE: To evaluate the efficacy of the Rural Pharmacological Intervention in Late Life (PILL) program, a quality improvement initiative in which a Boston-based pharmacist provided postdischarge telepharmacy care to veterans from rural Maine. METHODS: Using an automated screening tool, we identified 100 veterans aged 65 and older who had an acute care admission to VA medical centers in Boston or Maine and were at risk of problems with medication management. The PILL pharmacist called patients the week after hospital discharge to reconcile medications, assess adherence, and identify potentially inappropriate drugs...
September 8, 2016: Journal of Rural Health
Nengliang Yao, Héctor E Alcalá, Roger Anderson, Rajesh Balkrishnan
PURPOSE: To document cancer-related health disparities in Appalachia. METHODS: The current study investigated disparities in cancer incidence, mortality, and staging between rural Appalachians and those living outside of rural Appalachia. To accomplish this, mortality data for the United States from 1969 to 2011 were obtained from the National Center for Health Statistics (NCHS) using SEER(*) Stat. These data were used to compare trends in mortality between rural Appalachians, urban Appalachians, rural non-Appalachians, and urban non-Appalachians...
September 7, 2016: Journal of Rural Health
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No abstract text is available yet for this article.
September 2016: Journal of Rural Health
Jennifer Lee, Gina Capra, Thomas Klobucar
No abstract text is available yet for this article.
September 2016: Journal of Rural Health
Mary E Charlton, Michelle A Mengeling, Jennifer A Schlichting, Lan Jiang, Carolyn Turvey, Amal N Trivedi, Kenneth W Kizer, Alan N West
OBJECTIVE: To quantify use of VA and non-VA care among working-age veterans with private insurance by linking VA data to private health insurance plan (PHIP) data. METHODS: Demographics and utilization were compared between dual users of VA and non-VA systems versus single-system users for veterans < 65 living in 2 rural Midwestern states concurrently enrolled in VA health care and a PHIP for ≥ 1 complete federal fiscal year from 2000 to 2010. Chi-square and t-tests were used for univariate analyses...
September 2016: Journal of Rural Health
Ellen P Fischer, Jean C McSweeney, Patricia Wright, Ann Cheney, Geoffrey M Curran, Kathy Henderson, John C Fortney
PURPOSE: To better understand the attitudes, beliefs, and values that influence use of mental health care among rural veterans. METHODS: In-depth, semistructured interviews were conducted with 25 rural veterans and 11 rural mental health care providers in 4 states. Experienced qualitative interviewers asked participants about the attitudinal factors they thought most influenced rural veterans' decisions to seek and sustain mental health care. Verbatim transcriptions were analyzed using content analysis and constant comparison...
September 2016: Journal of Rural Health
Christopher J Koenig, Traci Abraham, Kara A Zamora, Coleen Hill, P Adam Kelly, Madeline Uddo, Michelle Hamilton, Jeffrey M Pyne, Karen H Seal
PURPOSE: Telephone motivational coaching has been shown to increase urban veteran mental health treatment initiation. However, no studies have tested telephone motivational coaching delivered by veteran peers to facilitate mental health treatment initiation and engagement. This study describes pre-implementation strategies with 8 Veterans Affairs (VA) community-based outpatient clinics in the West and Mid-South United States to adapt and implement a multisite pragmatic randomized controlled trial of telephone peer motivational coaching for rural veterans...
September 2016: Journal of Rural Health
Alan N West, Mary E Charlton
PURPOSE: To understand how working-age VA-enrolled veterans with commercial insurance use both VA and non-VA outpatient care, and how rural residence affects dual use, for common diagnoses and procedures. METHODS: We analyzed VA and non-VA outpatient treatment records for any months during 2005-2010 that New Hampshire veterans ages <65 were simultaneously enrolled in VA health care and commercial insurance (per NH's mandatory claims database). Controlling for covariates, we used analysis of variance to compare urban and rural VA users, non-VA users, and dual users on travel burden, diagnosis counts, duration in outpatient care, and visit frequencies, and logistic regressions to assess whether rural veterans were as likely to be seen for common conditions and procedures...
September 2016: Journal of Rural Health
Kristina M Cordasco, Michelle A Mengeling, Elizabeth M Yano, Donna L Washington
PURPOSE: Disparities in health and health care access between rural and urban Americans are well documented. There is evidence that these disparities are mirrored within the US veteran population. However, there are few studies assessing this issue among women veterans (WVs). METHODS: Using the 2008-2009 National Survey of Women Veterans, a population-based cross-sectional national telephone survey, we examined rural WVs' health and health care access compared to urban WVs...
September 2016: Journal of Rural Health
Mary E Charlton, Kevin A Matthews, Anne Gaglioti, Camden Bay, Bradley D McDowell, Marcia M Ward, Barcey T Levy
BACKGROUND: Colorectal cancer (CRC) screening has been shown to decrease the incidence of late-stage colorectal cancer, yet a substantial proportion of Americans do not receive screening. Those in rural areas may face barriers to colonoscopy services based on travel time, and previous studies have demonstrated lower screening among rural residents. Our purpose was to assess factors associated with late-stage CRC, and specifically to determine if longer travel time to colonoscopy was associated with late-stage CRC among an insured population in Iowa...
September 2016: Journal of Rural Health
Hongmei Wang, Fang Qiu, Eugene Boilesen, Preethy Nayar, Lina Lander, Kate Watkins, Shinobu Watanabe-Galloway
PURPOSE: The objective of this study was to examine the rural-urban differences in Medicare expenditures on end-of-life care for elderly cancer patients in the United States. METHODS: We analyzed Medicare claims data for 175,181 elderly adults with lung, colorectal, female breast, or prostate cancer diagnosis who died in 2008. The end-of-life costs were quantified as total Medicare expenditures for the last 12 months of care including inpatient, outpatient, physician services, hospice, home health, skilled nursing facilities (SNF), and durable medical expenditure...
September 2016: Journal of Rural Health
Deborah Cohen, Douglas G Manuel, Claudia Sanmartin
PURPOSE: The objective of this study was to explore Canadian rural-urban differences in the use of primary and secondary preventive diagnostic services for acute myocardial infarction (AMI)-a condition that is amenable to primary health care prevention efforts. METHODS: We examined primary and secondary preventive care services utilized 2 years prior to a patient's first AMI in a cohort of 30,491 patients in Ontario, Canada, from 2010 to 2012. Using logistic regression, rural-urban differences in lipid testing, glucose testing, stress testing, electrocardiograms, and echocardiograms in middle-age and senior patients were examined...
September 2016: Journal of Rural Health
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