Chronic diseases and conditions

Publications

Alphabetical list. You can also view by publication date.

Ambulatory Care Sensitive Condition Hospitalizations Among Rural Children
Date: 02 / 2007
Author(s): Michelle Casey, Alana Knudson, Michele Burlew, Gestur Davidson
Research center: Upper Midwest Rural Health Research Center
Topics: Children, Chronic diseases and conditions, Hospitals and clinics
Report Number: Working Paper No. 4
Ambulatory care sensitive conditions (ACSCs) are conditions for which inpatient hospital admissions could potentially be avoided through better outpatient care. Using hospital inpatient discharge data from six states, this study examined the relationships between children's inpatient hospitalizations for ACSCs, rural residence, poverty, health insurance, and physician supply. Admission rates for five conditions were examined: asthma, diabetes short-term complications, gastroenteritis, urinary tract infection and perforated appendix. Hospitalization rates for four of the five conditions are significantly higher for children living in rural areas than in urban areas. Condition-specific ACSC hospitalization rates for children also vary significantly across states, even after adjusting for rurality, poverty, uninsurance, and physician supply.
Ambulatory Care Sensitive Condition Hospitalizations Among Rural Children (Brief)
Date: 06 / 2007
Author(s): Michelle Casey, Alana Knudson, Michele Burlew, Gestur Davidson
Research center: Upper Midwest Rural Health Research Center
Topics: Children, Chronic diseases and conditions, Hospitals and clinics
Report Number: Policy Brief
Reports results from a study examining children's inpatient hospitalizations for Ambulatory Care Sensitive Conditions (ACSCs), rural residence, poverty, health insurance, and physician supply. Admission rates for five conditions were examined: asthma, diabetes short-term complications, gastroenteritis, urinary tract infection and perforated appendix.
Assessment Of Barriers To The Delivery Of Medicare Reimbursed Diabetes Self-Management Education In Rural Areas
Date: 09 / 2004
Author(s): M. Paige Powell, Saundra H. Glover, Janice C. Probst, Sarah B. Laditka
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Medicare
Explores the barriers that rural practitioners face in providing diabetes education services to Medicare beneficiaries. Survey results from a random sample of ADA-recognized diabetes education facilities indicated that insufficient Medicare reimbursement, staffing, institutional support as well as the ADA recognition process all constituted barriers to diabetes self-management education in rural areas.
Barriers Associated With the Delivery of Medicare Reimbursed Diabetes Self-Management Education
Date: 2005
Author(s): M. Paige Powell, Saundra H. Glover, Janice C. Probst, Sarah B. Laditka
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Medicare
Citation: Diabetes Educator, 31(6), 890-9
Describes the results of a study to explore the barriers that practitioners face in providing diabetes self-management education (DSME) to Medicare beneficiaries, with a special focus on barriers faced by rural providers. Barriers identified for rural providers include costs, reporting requirements, the shortage of designated specialists, fewer resources, high application fees for ADA recognition, staffing/institutional support, amount of Medicare reimbursement, lack of hours covered, and transportation.
Barriers to the Delivery of Medicare Reimbursed Diabetes Self-Management Education in Rural Areas (Fact Sheet)
Date: 2004
Research center: South Carolina Rural Health Research Center
Topic: Chronic diseases and conditions
Diabetes is one of the most prevalent chronic conditions among older adults in the United States, disproportionately affecting women and minorities. Diabetes Self-Management Education (DSME) 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.
Chronic Disease and Functional Limitation Among American Indian and Alaska Native Elders
Date: 2005
Author(s): Leander McDonald, Richard Ludtke, Kyle Muus
Research center: Upper Midwest Rural Health Research Center
Topics: American Indians and Alaska Natives, Chronic diseases and conditions, Minority health
Citation: Journal of Native Aging and Health, November-December 2005
Reports the results of an analysis of chronic disease's effect on functional limitation from a survey of 7,107 Native elders representing 143 tribes from 77 sites.
Chronic Disease in American Indian/Alaska Native Elders
Date: 2005
Author(s): Patricia L. Moulton, Leander R. McDonald, Kyle J. Muus, Alana D. Knudson, Richard L. Ludtke
Research center: Upper Midwest Rural Health Research Center
Topics: American Indians and Alaska Natives, Chronic diseases and conditions, Minority health
Citation: The IHS Primary Care Provider, 30(5), 53-54
Describes the prevalence of chronic diseases among Native American elders.
Chronic Disease Management In Rural And Underserved Areas: Patient Responses And Outcomes
Date: 11 / 2003
Research center: Southwest Rural Health Research Center
Topic: Chronic diseases and conditions
Report Number: Final Report
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 health care, quality of care, and resulted in positive clinical and financial outcomes. Respondents indicated that the most important DM program was diabetes, followed closely by DM programs for congestive heart failure, chronic obstructive pulmonary disease, asthma, and depression. DM programs resulted in 30% reduction in hospital inpatient stays and 17 % savings in health plan per member per month expenditures. A policy brief is also available. Report available on request.
Chronic Disease Management In Rural Areas
Date: 05 / 2004
Research center: Southwest Rural Health Research Center
Topic: Chronic diseases and conditions
Report Number: Policy Brief
Describes a study of six chronic disease management programs throughout the United States. Discusses issues related to chronic disease management in rural areas.
Chronic Disease Management in Rural Areas: A Research Update
Date: 2004
Research center: Southwest Rural Health Research Center
Topic: Chronic diseases and conditions
Discusses rural implementation of chronic disease management. Includes a list of benefits and barriers related to disease management.
Chronic Disease Management Systems (Registries) in Rural Health Care
Date: 05 / 2006
Author(s): Anne Skinner, Roslyn Fraser-Maginn, Keith J. Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topics: Chronic diseases and conditions, Quality, Technology
Report Number: Rural Policy Brief Vol. 11, Number 1 (PB2006-1 )
A Chronic Disease Management System (CDMS), or registry, is a tool that helps providers efficiently collect and analyze patient information to promote quality care for the rural population. The focus of this study was on the use of CDMSs in the management of diabetes, a disease prevalent in rural populations. Findings show that CDMSs are readily available to rural clinics and are being implemented and maintained by clinic staff with minimal expenditures for technology.
Diabetes & Hypertension among Rural Hispanics (Fact Sheet)
Date: 2004
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Health disparities, Hispanics
Fact sheet describing rates of diabetes and hypertension among rural Hispanics.
Diabetes & Hypertension among Rural Hispanics: Disparities in Diagnostics and Disease Management
Date: 2004
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Health disparities, Hispanics
Modest disparities in health were found among rural Hispanics when examining diabetes. Undiagnosed hypertension was higher for rural residents, both Hispanic and White, 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.
Diabetes and Cardiovascular Disease among Rural African Americans
Date: 02 / 2003
Research center: South Carolina Rural Health Research Center
Topics: African Americans, Chronic diseases and conditions, Minority health
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. Finds that rural African Americans with diagnosed diabetes have significantly higher rates of problems associated with diabetes than do urban whites; that rural and urban African Americans are more likely than rural and urban whites to have undiagnosed diabetes; that rural African Americans with diagnosed hypertension are more likely than urban whites to still have elevated diastolic blood pressure; and that rural African Americans have the highest prevalence of undiagnosed diastolic hypertension. The study documents the need to improve access to health care services in rural areas.
Diabetes and Cardiovascular Disease in Rural African Americans (Fact Sheet)
Date: 2003
Research center: South Carolina Rural Health Research Center
Topics: African Americans, Chronic diseases and conditions, Health disparities
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.
Diabetes and the Rural Safety Net
Date: 01 / 2002
Author(s): David Hartley, Erika Ziller, Caroline Macdonald
Research center: Maine Rural Health Research Center
Topics: Chronic diseases and conditions, Health insurance and the uninsured
Report Number: Working Paper No. 28
Investigates the extent to which the rural safety net is able to meet the needs of people with diabetes. Finds that small rural communities have a relatively greater need for safety net services to diabetics than their urban counterparts. To provide the needed array of services, medications, and support, a coordinated, team approach to care is needed. Such an approach would include the following elements: insurance coverage would be consistent with the standards of care; team management and care coordination would be facilitated, and the informal safety net would be formalized.
Diagnostic Risk Factors & Improvement Activities Among Rural African Americans (Fact Sheet)
Date: 2003
Research center: South Carolina Rural Health Research Center
Topics: African Americans, Chronic diseases and conditions
Discusses disease management among rural African Americans.
Diagnostic Risk Factors & Improvement Activities Among Rural Hispanics (Fact Sheet)
Date: 2003
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Hispanics
Discusses disease management among rural Hispanics.
Elements of Successful Rural Diabetes Management Programs
Date: 07 / 2006
Author(s): Roslyn Fraser, Anne M. Skinner, Keith J. Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topic: Chronic diseases and conditions
Report Number: P2006-2
Reports 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, such as low income, cultural differences, and long travel distances, to provide effective and efficient disease management.
Financing Rural Public Health Activities in Prevention and Health Promotion (Final Report)
Date: 06 / 2008
Author(s): Michael Meit, Lorraine Ettaro, Benjamin Hamlin, Bhumika Piya
Research center: Walsh Center for Rural Health Analysis
Topics: Chronic diseases and conditions, Health care financing, Health promotion and disease prevention, Public health
Final Report of a study to determine whether the flow of federal resources, from federal agencies, through states, and to communities, is influenced by state and local level public health infrastructure.
Handling the Handoff: Rural and Race-Based Disparities in Post Hospitalization Follow-up Care Among Medicare Beneficiaries with Diabetes
Date: 09 / 2011
Author(s): Kevin J. Bennett, Robert Chen, Medha Vyavaharkar, Saundra H. Glover, Janice C. Probst
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Health disparities, Hospitals and clinics, Minority health
Diabetes is one of the most common chronic diseases, affecting an estimated 23.6 million people in the United States (7.8% of the total population). Rural African American and Hispanic residents with diabetes are less likely to exhibit good control of their condition, putting them at greater risk for the consequences of this disease, such as kidney failure, blindness and amputation. Effective outpatient care is key to diabetes management. Absence of such care, conversely, may play a role in poorer diabetes control in rural areas. The present report uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America. It provides estimates of hospital admission rates for rural Medicare beneficiaries with diabetes, tracks the proportion of patients who receive adequate outpatient care post discharge, and assesses subsequent readmissions to the hospital. It also explores the potential for race-based disparities in care for diabetes.
Handling the Handoff: Rural and Race-Based Disparities in Post-Hospitalization Follow-Up Care Among Medicare Beneficiaries with Diabetes (Fact Sheet)
Date: 10 / 2011
Research center: South Carolina Rural Health Research Center
Topic: Chronic diseases and conditions
Uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America.
Hospitalization for Ambulatory Care Sensitive Conditions: Asthma, Diabetes, and Congestive Heart Failure in South Carolina
Date: 05 / 2003
Author(s): Janice C. Probst, Charity Moore, Elizabeth G. Baxley, John L. Lammie
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Health disparities
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.
Hospitalization for Ambulatory Care Sensitive Conditions: Congestive Heart Failure, Diabetes and Asthma in South Carolina (Fact Sheet)
Date: 2003
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Health disparities
Brief overview of findings from a study of hospitalizations in South Carolina for ambulatory care sensitive conditions. A full report is also available.
Hypertension, Diabetes, Cholesterol, Weight, and Weight Control Activities Among Non Metro Minority Adults
Date: 12 / 2002
Author(s): P. Daniel Patterson, Charity G. Moore, Janice C. Probst, Michael E. Samuels
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Health disparities, Minority health, Obesity
The 1998 National Health Interview Survey (NHIS) included a detailed examination of preventive health problems and behaviors. This report uses data from the 1998 NHIS to examine the prevalence of selected problems among rural populations, with an emphasis on rural minorities. ?Rural? was defined, following NHIS guidelines, as living in a non-MSA county.
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.
More May Be Better: Evidence of a Negative Relationship Between Physician Supply and Hospitalization for Ambulatory Care Sensitive Conditions
Date: 2005
Author(s): James N. Laditka, Sarah B. Laditka, Janice C. Probst
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Health services, Physicians
Citation: Health Services Research, 40(4), 1148-1166
The authors conducted an empirical test of the relationship between physician supply and hospitalization for ambulatory care sensitive conditions (ACSH). Principal findings showed that in the urban models for ages 0-17 physician supply has the largest negative adjusted relationship with ACSH. For ages 18-39 and 40-64, physician supply has the second largest negative adjusted relationship with ACSH. Physician supply was not associated with ACSH in rural areas. The authors conclude that physician supply is positively associated with the overall performance of the primary health care system in a large sample of urban counties of the United States.
National Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
Date: 12 / 2007
Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topics: Chronic diseases and conditions, Health care financing, Health policy, Hospitals and clinics
Report Number: Policy Brief No. PB2007-4
Documents the national magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
National Study of Lifetime Asthma Prevalence and Trends in Metro and Non-Metro Counties, 2000-2003 (Full Report)
Date: 01 / 2007
Author(s): J. Elizabeth Jackson, Mark P. Doescher, L. Gary Hart
Research center: WWAMI Rural Health Research Center
Topic: Chronic diseases and conditions
Report Number: Working Paper No. 108
Reports the findings of a study of the prevalence of and recent trends in asthma among adults residing in metropolitan and non-metropolitan counties in the United States. In 2003, the adjusted prevalence of lifetime asthma diagnosis was 12.0 percent for metropolitan counties and 11.0 percent for non-metropolitan counties (p < 0.001). Prevalence of lifetime asthma diagnosis trended upwards across the rural-urban spectrum between 2000 and 2003, and states with the highest 2003 prevalence and the greatest increase in prevalence among non-metropolitan residents were concentrated in the West Census region (e.g., Arizona, California, Oregon and Washington). Asthma prevalence in non-metropolitan counties was highest for those aged 18 to 34 (15.9%), the unemployed (13.5%), American Indians (12.7%) and women (12.4%).
National Study of Lifetime Asthma Prevalence and Trends in Metro and Non-Metro Counties, 2000-2003 (Project Summary)
Date: 01 / 2007
Research center: WWAMI Rural Health Research Center
Topic: Chronic diseases and conditions
Brief overview of findings of a study of the prevalence of and recent trends in asthma among adults residing in metropolitan and non-metropolitan counties in the United States. A full report is also available.
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.
Race and Place: Urban-Rural Differences in Health for Racial and Ethnic Minorities
Date: 03 / 2000
Author(s): Rebecca T. Slifkin, Laurie J. Goldsmith, Thomas C. Ricketts,
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topics: AIDS and HIV, Chronic diseases and conditions, Health disparities, Health promotion and disease prevention, Minority health
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.
Regional Variation in Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
Date: 12 / 2007
Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topics: Chronic diseases and conditions, Health care financing, Health policy, Hospitals and clinics
Report Number: Policy Brief No. PB2007-5
Estimates and documents the regional magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
Rural Diabetes Care Management Programs: An Inventory of Sample Programs in Six States
Date: 12 / 2005
Author(s): Roslyn S. Fraser-Maginn, Anne M. Skinner, Sue Nardie, Keith J. Mueller
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Topic: Chronic diseases and conditions
Developed to share key contact and program information with organizations that are interested in starting a chronic disease management (DM) program in their facility.
Rural Public Health Financing: The Relationship Between Infrastructure and Local Program Funding (Policy Brief)
Date: 06 / 2008
Author(s): Michael Meit, Lorraine Ettaro, Benjamin Hamlin, Bhumika Piya
Research center: Walsh Center for Rural Health Analysis
Topics: Chronic diseases and conditions, Health care financing, Health promotion and disease prevention, Public health
Report Number: W Series No. 14
The purpose of this study was to describe how federal funds for selected chronic disease prevention and health promotion activities are distributed to local health departments and non-governmental organizations at the local level and to identify infrastructure-related barriers that rural agencies may face in securing and using funds for such purposes. A central hypothesis was that the availability of federal funding for chronic disease prevention and health promotion activities may vary based on state and local public health infrastructural differences.
Rural Residence and Hispanic Ethnicity: Doubly Disadvantaged for Diabetes?
Date: 2006
Author(s): Richelle J. Koopman, Arch G. Mainous III, Mark E. Geesey
Research center: South Carolina Rural Health Research Center
Topics: Chronic diseases and conditions, Hispanics, Minority health
Citation: Journal of Rural Health, 22(1), 63-8
Reports the results of a study to determine whether living in a rural area and being Hispanic confers special risks for diagnosis and control of diabetes.

Topics Centers Researchers Other Resources Search		Chronic diseases and conditions Publications Alphabetical list. You can also view by publication date. Ambulatory Care Sensitive Condition Hospitalizations Among Rural Children Date: 02 / 2007 Author(s): Michelle Casey, Alana Knudson, Michele Burlew, Gestur Davidson Research center: Upper Midwest Rural Health Research Center Topics: Children, Chronic diseases and conditions, Hospitals and clinics Report Number: Working Paper No. 4 Ambulatory care sensitive conditions (ACSCs) are conditions for which inpatient hospital admissions could potentially be avoided through better outpatient care. Using hospital inpatient discharge data from six states, this study examined the relationships between children's inpatient hospitalizations for ACSCs, rural residence, poverty, health insurance, and physician supply. Admission rates for five conditions were examined: asthma, diabetes short-term complications, gastroenteritis, urinary tract infection and perforated appendix. Hospitalization rates for four of the five conditions are significantly higher for children living in rural areas than in urban areas. Condition-specific ACSC hospitalization rates for children also vary significantly across states, even after adjusting for rurality, poverty, uninsurance, and physician supply. Ambulatory Care Sensitive Condition Hospitalizations Among Rural Children (Brief) Date: 06 / 2007 Author(s): Michelle Casey, Alana Knudson, Michele Burlew, Gestur Davidson Research center: Upper Midwest Rural Health Research Center Topics: Children, Chronic diseases and conditions, Hospitals and clinics Report Number: Policy Brief Reports results from a study examining children's inpatient hospitalizations for Ambulatory Care Sensitive Conditions (ACSCs), rural residence, poverty, health insurance, and physician supply. Admission rates for five conditions were examined: asthma, diabetes short-term complications, gastroenteritis, urinary tract infection and perforated appendix. Assessment Of Barriers To The Delivery Of Medicare Reimbursed Diabetes Self-Management Education In Rural Areas Date: 09 / 2004 Author(s): M. Paige Powell, Saundra H. Glover, Janice C. Probst, Sarah B. Laditka Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Medicare Explores the barriers that rural practitioners face in providing diabetes education services to Medicare beneficiaries. Survey results from a random sample of ADA-recognized diabetes education facilities indicated that insufficient Medicare reimbursement, staffing, institutional support as well as the ADA recognition process all constituted barriers to diabetes self-management education in rural areas. Barriers Associated With the Delivery of Medicare Reimbursed Diabetes Self-Management Education Date: 2005 Author(s): M. Paige Powell, Saundra H. Glover, Janice C. Probst, Sarah B. Laditka Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Medicare Citation: Diabetes Educator, 31(6), 890-9 Describes the results of a study to explore the barriers that practitioners face in providing diabetes self-management education (DSME) to Medicare beneficiaries, with a special focus on barriers faced by rural providers. Barriers identified for rural providers include costs, reporting requirements, the shortage of designated specialists, fewer resources, high application fees for ADA recognition, staffing/institutional support, amount of Medicare reimbursement, lack of hours covered, and transportation. Barriers to the Delivery of Medicare Reimbursed Diabetes Self-Management Education in Rural Areas (Fact Sheet) Date: 2004 Research center: South Carolina Rural Health Research Center Topic: Chronic diseases and conditions Diabetes is one of the most prevalent chronic conditions among older adults in the United States, disproportionately affecting women and minorities. Diabetes Self-Management Education (DSME) 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. Chronic Disease and Functional Limitation Among American Indian and Alaska Native Elders Date: 2005 Author(s): Leander McDonald, Richard Ludtke, Kyle Muus Research center: Upper Midwest Rural Health Research Center Topics: American Indians and Alaska Natives, Chronic diseases and conditions, Minority health Citation: Journal of Native Aging and Health, November-December 2005 Reports the results of an analysis of chronic disease's effect on functional limitation from a survey of 7,107 Native elders representing 143 tribes from 77 sites. Chronic Disease in American Indian/Alaska Native Elders Date: 2005 Author(s): Patricia L. Moulton, Leander R. McDonald, Kyle J. Muus, Alana D. Knudson, Richard L. Ludtke Research center: Upper Midwest Rural Health Research Center Topics: American Indians and Alaska Natives, Chronic diseases and conditions, Minority health Citation: The IHS Primary Care Provider, 30(5), 53-54 Describes the prevalence of chronic diseases among Native American elders. Chronic Disease Management In Rural And Underserved Areas: Patient Responses And Outcomes Date: 11 / 2003 Research center: Southwest Rural Health Research Center Topic: Chronic diseases and conditions Report Number: Final Report 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 health care, quality of care, and resulted in positive clinical and financial outcomes. Respondents indicated that the most important DM program was diabetes, followed closely by DM programs for congestive heart failure, chronic obstructive pulmonary disease, asthma, and depression. DM programs resulted in 30% reduction in hospital inpatient stays and 17 % savings in health plan per member per month expenditures. A policy brief is also available. Report available on request. Chronic Disease Management In Rural Areas Date: 05 / 2004 Research center: Southwest Rural Health Research Center Topic: Chronic diseases and conditions Report Number: Policy Brief Describes a study of six chronic disease management programs throughout the United States. Discusses issues related to chronic disease management in rural areas. Chronic Disease Management in Rural Areas: A Research Update Date: 2004 Research center: Southwest Rural Health Research Center Topic: Chronic diseases and conditions Discusses rural implementation of chronic disease management. Includes a list of benefits and barriers related to disease management. Chronic Disease Management Systems (Registries) in Rural Health Care Date: 05 / 2006 Author(s): Anne Skinner, Roslyn Fraser-Maginn, Keith J. Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topics: Chronic diseases and conditions, Quality, Technology Report Number: Rural Policy Brief Vol. 11, Number 1 (PB2006-1 ) A Chronic Disease Management System (CDMS), or registry, is a tool that helps providers efficiently collect and analyze patient information to promote quality care for the rural population. The focus of this study was on the use of CDMSs in the management of diabetes, a disease prevalent in rural populations. Findings show that CDMSs are readily available to rural clinics and are being implemented and maintained by clinic staff with minimal expenditures for technology. Diabetes & Hypertension among Rural Hispanics (Fact Sheet) Date: 2004 Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Health disparities, Hispanics Fact sheet describing rates of diabetes and hypertension among rural Hispanics. Diabetes & Hypertension among Rural Hispanics: Disparities in Diagnostics and Disease Management Date: 2004 Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Health disparities, Hispanics Modest disparities in health were found among rural Hispanics when examining diabetes. Undiagnosed hypertension was higher for rural residents, both Hispanic and White, 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. Diabetes and Cardiovascular Disease among Rural African Americans Date: 02 / 2003 Research center: South Carolina Rural Health Research Center Topics: African Americans, Chronic diseases and conditions, Minority health 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. Finds that rural African Americans with diagnosed diabetes have significantly higher rates of problems associated with diabetes than do urban whites; that rural and urban African Americans are more likely than rural and urban whites to have undiagnosed diabetes; that rural African Americans with diagnosed hypertension are more likely than urban whites to still have elevated diastolic blood pressure; and that rural African Americans have the highest prevalence of undiagnosed diastolic hypertension. The study documents the need to improve access to health care services in rural areas. Diabetes and Cardiovascular Disease in Rural African Americans (Fact Sheet) Date: 2003 Research center: South Carolina Rural Health Research Center Topics: African Americans, Chronic diseases and conditions, Health disparities 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. Diabetes and the Rural Safety Net Date: 01 / 2002 Author(s): David Hartley, Erika Ziller, Caroline Macdonald Research center: Maine Rural Health Research Center Topics: Chronic diseases and conditions, Health insurance and the uninsured Report Number: Working Paper No. 28 Investigates the extent to which the rural safety net is able to meet the needs of people with diabetes. Finds that small rural communities have a relatively greater need for safety net services to diabetics than their urban counterparts. To provide the needed array of services, medications, and support, a coordinated, team approach to care is needed. Such an approach would include the following elements: insurance coverage would be consistent with the standards of care; team management and care coordination would be facilitated, and the informal safety net would be formalized. Diagnostic Risk Factors & Improvement Activities Among Rural African Americans (Fact Sheet) Date: 2003 Research center: South Carolina Rural Health Research Center Topics: African Americans, Chronic diseases and conditions Discusses disease management among rural African Americans. Diagnostic Risk Factors & Improvement Activities Among Rural Hispanics (Fact Sheet) Date: 2003 Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Hispanics Discusses disease management among rural Hispanics. Elements of Successful Rural Diabetes Management Programs Date: 07 / 2006 Author(s): Roslyn Fraser, Anne M. Skinner, Keith J. Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topic: Chronic diseases and conditions Report Number: P2006-2 Reports 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, such as low income, cultural differences, and long travel distances, to provide effective and efficient disease management. Financing Rural Public Health Activities in Prevention and Health Promotion (Final Report) Date: 06 / 2008 Author(s): Michael Meit, Lorraine Ettaro, Benjamin Hamlin, Bhumika Piya Research center: Walsh Center for Rural Health Analysis Topics: Chronic diseases and conditions, Health care financing, Health promotion and disease prevention, Public health Final Report of a study to determine whether the flow of federal resources, from federal agencies, through states, and to communities, is influenced by state and local level public health infrastructure. Handling the Handoff: Rural and Race-Based Disparities in Post Hospitalization Follow-up Care Among Medicare Beneficiaries with Diabetes Date: 09 / 2011 Author(s): Kevin J. Bennett, Robert Chen, Medha Vyavaharkar, Saundra H. Glover, Janice C. Probst Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Health disparities, Hospitals and clinics, Minority health Diabetes is one of the most common chronic diseases, affecting an estimated 23.6 million people in the United States (7.8% of the total population). Rural African American and Hispanic residents with diabetes are less likely to exhibit good control of their condition, putting them at greater risk for the consequences of this disease, such as kidney failure, blindness and amputation. Effective outpatient care is key to diabetes management. Absence of such care, conversely, may play a role in poorer diabetes control in rural areas. The present report uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America. It provides estimates of hospital admission rates for rural Medicare beneficiaries with diabetes, tracks the proportion of patients who receive adequate outpatient care post discharge, and assesses subsequent readmissions to the hospital. It also explores the potential for race-based disparities in care for diabetes. Handling the Handoff: Rural and Race-Based Disparities in Post-Hospitalization Follow-Up Care Among Medicare Beneficiaries with Diabetes (Fact Sheet) Date: 10 / 2011 Research center: South Carolina Rural Health Research Center Topic: Chronic diseases and conditions Uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America. Hospitalization for Ambulatory Care Sensitive Conditions: Asthma, Diabetes, and Congestive Heart Failure in South Carolina Date: 05 / 2003 Author(s): Janice C. Probst, Charity Moore, Elizabeth G. Baxley, John L. Lammie Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Health disparities 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. Hospitalization for Ambulatory Care Sensitive Conditions: Congestive Heart Failure, Diabetes and Asthma in South Carolina (Fact Sheet) Date: 2003 Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Health disparities Brief overview of findings from a study of hospitalizations in South Carolina for ambulatory care sensitive conditions. A full report is also available. Hypertension, Diabetes, Cholesterol, Weight, and Weight Control Activities Among Non Metro Minority Adults Date: 12 / 2002 Author(s): P. Daniel Patterson, Charity G. Moore, Janice C. Probst, Michael E. Samuels Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Health disparities, Minority health, Obesity The 1998 National Health Interview Survey (NHIS) included a detailed examination of preventive health problems and behaviors. This report uses data from the 1998 NHIS to examine the prevalence of selected problems among rural populations, with an emphasis on rural minorities. ?Rural? was defined, following NHIS guidelines, as living in a non-MSA county. 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. More May Be Better: Evidence of a Negative Relationship Between Physician Supply and Hospitalization for Ambulatory Care Sensitive Conditions Date: 2005 Author(s): James N. Laditka, Sarah B. Laditka, Janice C. Probst Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Health services, Physicians Citation: Health Services Research, 40(4), 1148-1166 The authors conducted an empirical test of the relationship between physician supply and hospitalization for ambulatory care sensitive conditions (ACSH). Principal findings showed that in the urban models for ages 0-17 physician supply has the largest negative adjusted relationship with ACSH. For ages 18-39 and 40-64, physician supply has the second largest negative adjusted relationship with ACSH. Physician supply was not associated with ACSH in rural areas. The authors conclude that physician supply is positively associated with the overall performance of the primary health care system in a large sample of urban counties of the United States. National Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions Date: 12 / 2007 Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topics: Chronic diseases and conditions, Health care financing, Health policy, Hospitals and clinics Report Number: Policy Brief No. PB2007-4 Documents the national magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals. National Study of Lifetime Asthma Prevalence and Trends in Metro and Non-Metro Counties, 2000-2003 (Full Report) Date: 01 / 2007 Author(s): J. Elizabeth Jackson, Mark P. Doescher, L. Gary Hart Research center: WWAMI Rural Health Research Center Topic: Chronic diseases and conditions Report Number: Working Paper No. 108 Reports the findings of a study of the prevalence of and recent trends in asthma among adults residing in metropolitan and non-metropolitan counties in the United States. In 2003, the adjusted prevalence of lifetime asthma diagnosis was 12.0 percent for metropolitan counties and 11.0 percent for non-metropolitan counties (p < 0.001). Prevalence of lifetime asthma diagnosis trended upwards across the rural-urban spectrum between 2000 and 2003, and states with the highest 2003 prevalence and the greatest increase in prevalence among non-metropolitan residents were concentrated in the West Census region (e.g., Arizona, California, Oregon and Washington). Asthma prevalence in non-metropolitan counties was highest for those aged 18 to 34 (15.9%), the unemployed (13.5%), American Indians (12.7%) and women (12.4%). National Study of Lifetime Asthma Prevalence and Trends in Metro and Non-Metro Counties, 2000-2003 (Project Summary) Date: 01 / 2007 Research center: WWAMI Rural Health Research Center Topic: Chronic diseases and conditions Brief overview of findings of a study of the prevalence of and recent trends in asthma among adults residing in metropolitan and non-metropolitan counties in the United States. A full report is also available. 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. Race and Place: Urban-Rural Differences in Health for Racial and Ethnic Minorities Date: 03 / 2000 Author(s): Rebecca T. Slifkin, Laurie J. Goldsmith, Thomas C. Ricketts, Research center: North Carolina Rural Health Research and Policy Analysis Center Topics: AIDS and HIV, Chronic diseases and conditions, Health disparities, Health promotion and disease prevention, Minority health 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. Regional Variation in Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions Date: 12 / 2007 Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topics: Chronic diseases and conditions, Health care financing, Health policy, Hospitals and clinics Report Number: Policy Brief No. PB2007-5 Estimates and documents the regional magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals. Rural Diabetes Care Management Programs: An Inventory of Sample Programs in Six States Date: 12 / 2005 Author(s): Roslyn S. Fraser-Maginn, Anne M. Skinner, Sue Nardie, Keith J. Mueller Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis Topic: Chronic diseases and conditions Developed to share key contact and program information with organizations that are interested in starting a chronic disease management (DM) program in their facility. Rural Public Health Financing: The Relationship Between Infrastructure and Local Program Funding (Policy Brief) Date: 06 / 2008 Author(s): Michael Meit, Lorraine Ettaro, Benjamin Hamlin, Bhumika Piya Research center: Walsh Center for Rural Health Analysis Topics: Chronic diseases and conditions, Health care financing, Health promotion and disease prevention, Public health Report Number: W Series No. 14 The purpose of this study was to describe how federal funds for selected chronic disease prevention and health promotion activities are distributed to local health departments and non-governmental organizations at the local level and to identify infrastructure-related barriers that rural agencies may face in securing and using funds for such purposes. A central hypothesis was that the availability of federal funding for chronic disease prevention and health promotion activities may vary based on state and local public health infrastructural differences. Rural Residence and Hispanic Ethnicity: Doubly Disadvantaged for Diabetes? Date: 2006 Author(s): Richelle J. Koopman, Arch G. Mainous III, Mark E. Geesey Research center: South Carolina Rural Health Research Center Topics: Chronic diseases and conditions, Hispanics, Minority health Citation: Journal of Rural Health, 22(1), 63-8 Reports the results of a study to determine whether living in a rural area and being Hispanic confers special risks for diagnosis and control of diabetes.