Aging

Publications

Alphabetical list. You can also view by publication date.

Access to Care Among Rural Minorities: Older Adults
Date: 10 / 2002
Author(s): Janice C. Probst, Michael E. Samuels, Charity G. Moore, Joette Gdovin
Research center: South Carolina Rural Health Research Center
Topics: Aging, Health disparities, Minority health, Poverty
Profiles health status of, and use of physicians by, non-metro older adults. Programmatic recommendations based on the findings: maintain programs that encourage providers to practice in non-metro areas, pay particular attention to the problems of the near-poor African-American elderly, and foster coalitions linking providers with voluntary community-based organizations to increase support services to elderly non-metro populations.
Access to Care Among Rural Minorities: Older Adults (Appendix - Methods, Data, and Detailed Tables)
Date: 10 / 2002
Author(s): Janice C. Probst, Michael E. Samuels, Charity G. Moore, Joette Gdovin
Research center: South Carolina Rural Health Research Center
Topics: Aging, Health disparities, Minority health, Poverty
Appendix of report on health status and health services use among poor and minority older adults in non-metro areas.
Disability Burdens among Older Americans in Rural and Urban Area
Date: 2005
Research center: South Carolina Rural Health Research Center
Topics: Aging, Disabilities
Examines differences in disability-free and disabled life expectancy among rural or urban residents, using an indicator called "health expectancy."
Do Rural Elders Have Limited Access to Medicare Hospice Services?
Date: 2004
Author(s): Beth A. Virnig, Ira S. Moscovice, Sara B. Durham, Michelle M. Casey
Research centers: Minnesota Rural Health Research Center , Upper Midwest Rural Health Research Center
Topics: Aging, Hospice and palliative care, Medicare
Citation: Journal of the American Geriatrics Society, 52(5), 731-5
The authors examined whether there are urban-rural differences in use of the Medicare hospice benefit before death and whether those differences suggest that there is a problem with access to hospice care for rural Medicare beneficiaries. Rates of hospice care before death were negatively associated with degree of rurality. The lowest rate of hospice use, 15.2% of deaths, was seen in rural areas not adjacent to an urban area. The highest rate of use, 22.2% of deaths, was seen in urban areas. Rural areas adjacent to urban areas had an intermediate level of hospice use (17.0% of deaths). Hospices based in rural areas had a smaller number of elderly patients each year than hospices based in urban areas, and were more likely to have very low volumes. The authors conclude that the consistently lower use of Medicare hospice services before death and smaller sizes of rural hospices suggests that the combination of Medicare hospice payment policies and hospice volumes are problematic for rural hospices. Adjusting Medicare payment policies might be a critical step to assure availability of hospice services for terminally ill beneficiaries regardless of where they live.
Effect of the Doctor-Patient Relationship on Emergency Department Use Among the Elderly
Date: 01 / 2000
Author(s): Roger A Rosenblatt, GE Wright, Laura-Mae Baldwin, Leighton Chan, P Clitherow, Frederick M Chen, L Gary Hart
Research center: WWAMI Rural Health Research Center
Topics: Aging, Emergency medical services (EMS), Physicians
Citation: American Journal of Public Health, 90(1), 97-102
OBJECTIVES: This study sought to determine the rate of emergency department use among the elderly and examined whether that use is reduced if the patient has a principal-care physician.
METHODS: The Health Care Financing Administration's National Claims History File was used to study emergency department use by Medicare patients older than 65 years in Washington State during 1994. RESULTS: A total of 18.1% of patients had 1 or more emergency department visits during the study year; the rate increased with age and illness severity. Patients with principal-care physicians were much less likely to use the emergency department for every category of disease severity. After case mix, Medicaid eligibility, and rural/urban residence were controlled for, the odds ratio for having any emergency department visit was 0.47 for patients with a generalist principal-care physician and 0.58 for patients with a specialist principal-care physician.
CONCLUSIONS: The rate of emergency department use among the elderly is substantial, and most visits are for serious medical problems. The presence of a continuous relationship with a physician--regardless of specialty--may reduce emergency department use.
Emergency Department Use by the Rural Elderly
Date: 2000
Author(s): Denise M Lishner,Roger A Rosenblatt, Laura-Mae Baldwin, L Gary Hart
Research center: WWAMI Rural Health Research Center
Topics: Aging, Emergency medical services (EMS), Hospitals and clinics
Citation: Journal of Emergency Medicine, 18(3), 289-297
This study uses Medicare data to compare emergency department (ED) use by rural and urban elderly beneficiaries. The U.S. Health Care Financing Administration's National Claims File was used to identify services provided to Medicare beneficiaries in Washington State in 1994. Patients were classified by urban, adjacent rural, or remote rural residence. We identified ED visits and associated diagnostic codes, assigned severity levels for presenting conditions, and determined the specialties of physicians providing ED services. The rural elderly living in remote areas are 13% less likely to visit the ED than their urban counterparts. Causes of ED use by the elderly do not vary meaningfully by location. Most ED visits by this group are for conditions that seem appropriate for this setting. Given the similarity of diagnostic conditions associated with ED visits, rural EDs must be capable of dealing with the same range of emergency conditions as urban EDs.
Health Insurance Coverage and Access to Health Care for American Indian and Alaska Native Elders
Date: 10 / 2007
Research center: Upper Midwest Rural Health Research Center
Topics: Aging, American Indians and Alaska Natives, Health insurance and the uninsured, Minority health
Policy brief reporting findings from a study assessing health insurance coverage and access to health care among American Indian and Alaska Native elders (Native elders), using data from a national survey that included more than 8,300 Native elders.
Health Insurance Coverage Of The Rural And Urban Near Elderly
Date: 10 / 2003
Author(s): Erika C. Ziller, Andrew F. Coburn
Research center: Maine Rural Health Research Center
Topics: Aging, Health insurance and the uninsured
Report Number: Working Paper No. 27
Reports the results of a study that used data from the 1996-1998 Medical Expenditure Panel Survey (MEPS) to address two principal research questions related to health insurance coverage for the rural near elderly. Findings indicate that the rural near elderly are both more likely to be uninsured and to be in fair or poor health, and when the near elderly become uninsured they may have a much more difficult time regaining health insurance than younger groups. This issue may be even more problematic in rural areas as the findings indicate that 14% of the rural near elderly are uninsured for the entire survey year, compared to 10% of the urban near elderly.
Health Risks Factors Among American Indians and Alaska Native Elders
Date: 2006
Author(s): Leander McDonald, Richard Ludtke, Kyle Muus
Research center: Upper Midwest Rural Health Research Center
Topics: Aging, American Indians and Alaska Natives, Minority health
Citation: Journal of Native Aging and Health, July-August 2006, 1(2), 17-24
Chronic disease rates are higher among American Indian and Alaska Native elders although they exercise more and have higher rates of participation in multiple exercise activities. Research concerning the relationship between chronic disease and health risk factors is limited for American Indian and Alaska Native elder populations. This paper indicated results of an analysis of the effect of risk factors on chronic disease from a survey of 9,296 Native elders, representing 171 tribes from 88 sites. The sampling design employed systematic random sampling for larger tribes, with smaller tribes (fewer than 200) interviewing all or the majority of their elders. The data suggest that smokers, drinkers, and non-exercisers are at increase risk for chronic disease.
Improving the Quality of Outpatient Care for Older Patients with Diabetes: Lessons from a Comparison of Rural and Urban Communities
Date: 08 / 2001
Author(s): Roger A. Rosenblatt, Laura-Mae Baldwin, Leighton Chan, Meredith A. Fordyce, Irl B. Hirsch, Jerry P. Palmer, George E. Wright, L. Gary Hart
Research center: WWAMI Rural Health Research Center
Topics: Aging, Chronic diseases and conditions, Quality
Citation: Journal of Family Practice, 50(8), 676-680
Compares the quality of diabetic care received by patients in rural and urban communities in Washington State. Among the findings: Generalists provided most diabetic care in all locations. Patients living in small rural towns received almost half their outpatient care in larger communities. Patients living in large rural towns remote from metropolitan areas were more likely to have received the recommended tests than patients in all other groups. Patients who saw an endocrinologist at least once during the year were more likely to have received the recommended tests. 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.
Nursing Homes in Rural America
Date: 2003
Research center: Southwest Rural Health Research Center
Topics: Aging, Long term care
Policy brief that discusses the main findings of a 2000 survey of 17,000 nursing homes related to rural elderly.
Prevalence of Chronic Disease Among American Indian and Alaska Native Elders
Date: 10 / 2005
Author(s): Patricia Moulton, Leander McDonald, Kyle Muus, Alana Knudson, Mary Wakefield, Richard Ludtke
Research center: Upper Midwest Rural Health Research Center
Topics: Aging, American Indians and Alaska Natives, Chronic diseases and conditions, Minority health
Examines chronic disease prevalence and functional limitations among American Indian/Alaska Natives by rurality, gender, age, health care access, and health behaviors. Includes policy recommendations.
Rural Beneficiary Need for a Medicare Drug Benefit Delivered Through the Rural Delivery System
Date: 10 / 2002
Author(s): Keith Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topics: Aging, Pharmacy and prescription drugs, Poverty
Elderly who live below the poverty level, seniors without prescription drug coverage, Medicare plans
Rural Minority Elders (Fact Sheet)
Date: 2003
Research center: South Carolina Rural Health Research Center
Topics: Aging, Health insurance and the uninsured, Minority health, Rural statistics and demographics
Fact sheet providing data on health status, health insurance coverage, education and income of rural elders.

Topics Centers Researchers Other Resources Search		Aging Publications Alphabetical list. You can also view by publication date. Access to Care Among Rural Minorities: Older Adults Date: 10 / 2002 Author(s): Janice C. Probst, Michael E. Samuels, Charity G. Moore, Joette Gdovin Research center: South Carolina Rural Health Research Center Topics: Aging, Health disparities, Minority health, Poverty Profiles health status of, and use of physicians by, non-metro older adults. Programmatic recommendations based on the findings: maintain programs that encourage providers to practice in non-metro areas, pay particular attention to the problems of the near-poor African-American elderly, and foster coalitions linking providers with voluntary community-based organizations to increase support services to elderly non-metro populations. Access to Care Among Rural Minorities: Older Adults (Appendix - Methods, Data, and Detailed Tables) Date: 10 / 2002 Author(s): Janice C. Probst, Michael E. Samuels, Charity G. Moore, Joette Gdovin Research center: South Carolina Rural Health Research Center Topics: Aging, Health disparities, Minority health, Poverty Appendix of report on health status and health services use among poor and minority older adults in non-metro areas. Disability Burdens among Older Americans in Rural and Urban Area Date: 2005 Research center: South Carolina Rural Health Research Center Topics: Aging, Disabilities Examines differences in disability-free and disabled life expectancy among rural or urban residents, using an indicator called "health expectancy." Do Rural Elders Have Limited Access to Medicare Hospice Services? Date: 2004 Author(s): Beth A. Virnig, Ira S. Moscovice, Sara B. Durham, Michelle M. Casey Research centers: Minnesota Rural Health Research Center , Upper Midwest Rural Health Research Center Topics: Aging, Hospice and palliative care, Medicare Citation: Journal of the American Geriatrics Society, 52(5), 731-5 The authors examined whether there are urban-rural differences in use of the Medicare hospice benefit before death and whether those differences suggest that there is a problem with access to hospice care for rural Medicare beneficiaries. Rates of hospice care before death were negatively associated with degree of rurality. The lowest rate of hospice use, 15.2% of deaths, was seen in rural areas not adjacent to an urban area. The highest rate of use, 22.2% of deaths, was seen in urban areas. Rural areas adjacent to urban areas had an intermediate level of hospice use (17.0% of deaths). Hospices based in rural areas had a smaller number of elderly patients each year than hospices based in urban areas, and were more likely to have very low volumes. The authors conclude that the consistently lower use of Medicare hospice services before death and smaller sizes of rural hospices suggests that the combination of Medicare hospice payment policies and hospice volumes are problematic for rural hospices. Adjusting Medicare payment policies might be a critical step to assure availability of hospice services for terminally ill beneficiaries regardless of where they live. Effect of the Doctor-Patient Relationship on Emergency Department Use Among the Elderly Date: 01 / 2000 Author(s): Roger A Rosenblatt, GE Wright, Laura-Mae Baldwin, Leighton Chan, P Clitherow, Frederick M Chen, L Gary Hart Research center: WWAMI Rural Health Research Center Topics: Aging, Emergency medical services (EMS), Physicians Citation: American Journal of Public Health, 90(1), 97-102 OBJECTIVES: This study sought to determine the rate of emergency department use among the elderly and examined whether that use is reduced if the patient has a principal-care physician. METHODS: The Health Care Financing Administration's National Claims History File was used to study emergency department use by Medicare patients older than 65 years in Washington State during 1994. RESULTS: A total of 18.1% of patients had 1 or more emergency department visits during the study year; the rate increased with age and illness severity. Patients with principal-care physicians were much less likely to use the emergency department for every category of disease severity. After case mix, Medicaid eligibility, and rural/urban residence were controlled for, the odds ratio for having any emergency department visit was 0.47 for patients with a generalist principal-care physician and 0.58 for patients with a specialist principal-care physician. CONCLUSIONS: The rate of emergency department use among the elderly is substantial, and most visits are for serious medical problems. The presence of a continuous relationship with a physician--regardless of specialty--may reduce emergency department use. Emergency Department Use by the Rural Elderly Date: 2000 Author(s): Denise M Lishner,Roger A Rosenblatt, Laura-Mae Baldwin, L Gary Hart Research center: WWAMI Rural Health Research Center Topics: Aging, Emergency medical services (EMS), Hospitals and clinics Citation: Journal of Emergency Medicine, 18(3), 289-297 This study uses Medicare data to compare emergency department (ED) use by rural and urban elderly beneficiaries. The U.S. Health Care Financing Administration's National Claims File was used to identify services provided to Medicare beneficiaries in Washington State in 1994. Patients were classified by urban, adjacent rural, or remote rural residence. We identified ED visits and associated diagnostic codes, assigned severity levels for presenting conditions, and determined the specialties of physicians providing ED services. The rural elderly living in remote areas are 13% less likely to visit the ED than their urban counterparts. Causes of ED use by the elderly do not vary meaningfully by location. Most ED visits by this group are for conditions that seem appropriate for this setting. Given the similarity of diagnostic conditions associated with ED visits, rural EDs must be capable of dealing with the same range of emergency conditions as urban EDs. Health Insurance Coverage and Access to Health Care for American Indian and Alaska Native Elders Date: 10 / 2007 Research center: Upper Midwest Rural Health Research Center Topics: Aging, American Indians and Alaska Natives, Health insurance and the uninsured, Minority health Policy brief reporting findings from a study assessing health insurance coverage and access to health care among American Indian and Alaska Native elders (Native elders), using data from a national survey that included more than 8,300 Native elders. Health Insurance Coverage Of The Rural And Urban Near Elderly Date: 10 / 2003 Author(s): Erika C. Ziller, Andrew F. Coburn Research center: Maine Rural Health Research Center Topics: Aging, Health insurance and the uninsured Report Number: Working Paper No. 27 Reports the results of a study that used data from the 1996-1998 Medical Expenditure Panel Survey (MEPS) to address two principal research questions related to health insurance coverage for the rural near elderly. Findings indicate that the rural near elderly are both more likely to be uninsured and to be in fair or poor health, and when the near elderly become uninsured they may have a much more difficult time regaining health insurance than younger groups. This issue may be even more problematic in rural areas as the findings indicate that 14% of the rural near elderly are uninsured for the entire survey year, compared to 10% of the urban near elderly. Health Risks Factors Among American Indians and Alaska Native Elders Date: 2006 Author(s): Leander McDonald, Richard Ludtke, Kyle Muus Research center: Upper Midwest Rural Health Research Center Topics: Aging, American Indians and Alaska Natives, Minority health Citation: Journal of Native Aging and Health, July-August 2006, 1(2), 17-24 Chronic disease rates are higher among American Indian and Alaska Native elders although they exercise more and have higher rates of participation in multiple exercise activities. Research concerning the relationship between chronic disease and health risk factors is limited for American Indian and Alaska Native elder populations. This paper indicated results of an analysis of the effect of risk factors on chronic disease from a survey of 9,296 Native elders, representing 171 tribes from 88 sites. The sampling design employed systematic random sampling for larger tribes, with smaller tribes (fewer than 200) interviewing all or the majority of their elders. The data suggest that smokers, drinkers, and non-exercisers are at increase risk for chronic disease. Improving the Quality of Outpatient Care for Older Patients with Diabetes: Lessons from a Comparison of Rural and Urban Communities Date: 08 / 2001 Author(s): Roger A. Rosenblatt, Laura-Mae Baldwin, Leighton Chan, Meredith A. Fordyce, Irl B. Hirsch, Jerry P. Palmer, George E. Wright, L. Gary Hart Research center: WWAMI Rural Health Research Center Topics: Aging, Chronic diseases and conditions, Quality Citation: Journal of Family Practice, 50(8), 676-680 Compares the quality of diabetic care received by patients in rural and urban communities in Washington State. Among the findings: Generalists provided most diabetic care in all locations. Patients living in small rural towns received almost half their outpatient care in larger communities. Patients living in large rural towns remote from metropolitan areas were more likely to have received the recommended tests than patients in all other groups. Patients who saw an endocrinologist at least once during the year were more likely to have received the recommended tests. 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. Nursing Homes in Rural America Date: 2003 Research center: Southwest Rural Health Research Center Topics: Aging, Long term care Policy brief that discusses the main findings of a 2000 survey of 17,000 nursing homes related to rural elderly. Prevalence of Chronic Disease Among American Indian and Alaska Native Elders Date: 10 / 2005 Author(s): Patricia Moulton, Leander McDonald, Kyle Muus, Alana Knudson, Mary Wakefield, Richard Ludtke Research center: Upper Midwest Rural Health Research Center Topics: Aging, American Indians and Alaska Natives, Chronic diseases and conditions, Minority health Examines chronic disease prevalence and functional limitations among American Indian/Alaska Natives by rurality, gender, age, health care access, and health behaviors. Includes policy recommendations. Rural Beneficiary Need for a Medicare Drug Benefit Delivered Through the Rural Delivery System Date: 10 / 2002 Author(s): Keith Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topics: Aging, Pharmacy and prescription drugs, Poverty Elderly who live below the poverty level, seniors without prescription drug coverage, Medicare plans Rural Minority Elders (Fact Sheet) Date: 2003 Research center: South Carolina Rural Health Research Center Topics: Aging, Health insurance and the uninsured, Minority health, Rural statistics and demographics Fact sheet providing data on health status, health insurance coverage, education and income of rural elders. Related Topics These related topics also list publications: Long term care (22 items)

Aging

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