Chronic diseases and conditions

Publications

Listed by publication date. You can also view these publications alphabetically.

2008

• Rural Public Health Financing: The Relationship Between Infrastructure and Local Program Funding (Policy Brief)
  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
  Date: 06 / 2008
  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.
• Financing Rural Public Health Activities in Prevention and Health Promotion (Final Report)
  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
  Date: 06 / 2008
  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.

2007

• National Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
  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
  Date: 12 / 2007
  Documents the national magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
• Regional Variation in Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
  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
  Date: 12 / 2007
  Estimates and documents the regional magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
• Ambulatory Care Sensitive Condition Hospitalizations Among Rural Children (Brief)
  Author(s): Michelle Casey, Alana Knudson, Michele Burlew, Gestur Davidson
  Research center: Upper Midwest Rural Health Research Center
  Topics: Children, Chronic diseases and conditions, Hospice and palliative care
  Report Number: Policy Brief
  Date: 06 / 2007
  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.
• Ambulatory Care Sensitive Condition Hospitalizations Among Rural Children
  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
  Date: 02 / 2007
  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.
• National Study of Lifetime Asthma Prevalence and Trends in Metro and Non-Metro Counties, 2000-2003 (Project Summary)
  Research center: WWAMI Rural Health Research Center
  Topic: Chronic diseases and conditions
  Date: 01 / 2007
  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.
• National Study of Lifetime Asthma Prevalence and Trends in Metro and Non-Metro Counties, 2000-2003 (Full Report)
  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
  Date: 01 / 2007
  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%).

2006

• Elements of Successful Rural Diabetes Management Programs
  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
  Date: 07 / 2006
  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.
• Chronic Disease Management Systems (Registries) in Rural Health Care
  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 )
  Date: 05 / 2006
  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.
• Rural Residence and Hispanic Ethnicity: Doubly Disadvantaged for Diabetes?
  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
  Date: 2006
  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.

2005

• Rural Diabetes Care Management Programs: An Inventory of Sample Programs in Six States
  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
  Date: 12 / 2005
  Developed to share key contact and program information with organizations that are interested in starting a chronic disease management (DM) program in their facility.
• Prevalence of Chronic Disease Among American Indian and Alaska Native Elders
  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
  Date: 10 / 2005
  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.
• Chronic Disease in American Indian/Alaska Native Elders
  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
  Date: 2005
  Describes the prevalence of chronic diseases among Native American elders.
• Barriers Associated With the Delivery of Medicare Reimbursed Diabetes Self-Management Education
  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
  Date: 2005
  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.
• Chronic Disease and Functional Limitation Among American Indian and Alaska Native Elders
  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
  Date: 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.
• More May Be Better: Evidence of a Negative Relationship Between Physician Supply and Hospitalization for Ambulatory Care Sensitive Conditions
  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
  Date: 2005
  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.

2004

• Assessment Of Barriers To The Delivery Of Medicare Reimbursed Diabetes Self-Management Education In Rural Areas
  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
  Date: 09 / 2004
  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. Executive summary available online.
• Chronic Disease Management In Rural Areas
  Research center: Southwest Rural Health Research Center
  Topic: Chronic diseases and conditions
  Report Number: Policy Brief
  Date: 05 / 2004
  Describes a study of six chronic disease management programs throughout the United States. Discusses issues related to chronic disease management in rural areas.
• Diabetes & Hypertension among Rural Hispanics
  Research center: South Carolina Rural Health Research Center
  Topics: Chronic diseases and conditions, Health disparities, Hispanics
  Date: 2004
  Fact sheet describing rates of diabetes and hypertension among rural Hispanics.
• Barriers to the Delivery of Medicare Reimbursed Diabetes Self-Management Education in Rural Areas
  Research center: South Carolina Rural Health Research Center
  Topic: Chronic diseases and conditions
  Date: 2004
  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.
• Diabetes & Hypertension among Rural Hispanics: Disparities in Diagnostics and Disease Management (Executive Summary)
  Research center: South Carolina Rural Health Research Center
  Topics: Chronic diseases and conditions, Health disparities, Hispanics
  Date: 2004
  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.
• Chronic Disease Management in Rural Areas: A Research Update
  Research center: Southwest Rural Health Research Center
  Topic: Chronic diseases and conditions
  Date: 2004
  Discusses rural implementation of chronic disease management. Includes a list of benefits and barriers related to disease management.

2003

• Chronic Disease Management In Rural And Underserved Areas: Patient Responses And Outcomes
  Research center: Southwest Rural Health Research Center
  Topic: Chronic diseases and conditions
  Report Number: Final Report
  Date: 11 / 2003
  Findings from site visits and interviews with six chronic disease management (DM) programs across the United States indicated DM programs were extremely important in the areas of patient 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.
• Hospitalization for Ambulatory Care Sensitive Conditions: Asthma, Diabetes, and Congestive Heart Failure in South Carolina (Executive Summary)
  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
  Date: 05 / 2003
  Hospitalization rates for ambulatory care sensitive conditions, diseases for which primary care in the preceding six months could have reduced or eliminated the need for hospitalization, are a commonly used indicator of disparities in access to care.
• Diabetes and Cardiovascular Disease among Rural African Americans
  Research center: South Carolina Rural Health Research Center
  Topics: African Americans, Chronic diseases and conditions, Minority health
  Date: 02 / 2003
  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. Executive summary available online.
• Hospitalization for Ambulatory Care Sensitive Conditions: Congestive Heart Failure, Diabetes and Asthma in South Carolina (Fact Sheet)
  Research center: South Carolina Rural Health Research Center
  Topics: Chronic diseases and conditions, Health disparities
  Date: 2003
  Brief overview of findings from a study of hospitalizations in South Carolina for ambulatory care sensitive conditions. A full report is also available.
• Diabetes and Cardiovascular Disease in Rural African Americans
  Research center: South Carolina Rural Health Research Center
  Topics: African Americans, Chronic diseases and conditions, Health disparities
  Date: 2003
  Previous research has indicated that persons living in rural areas are more vulnerable to poor health than those living in urban areas. Minorities in particular are more vulnerable to poor health than non-minorities.
• Diagnostic Risk Factors & Improvement Activities Among Rural African Americans
  Research center: South Carolina Rural Health Research Center
  Topics: African Americans, Chronic diseases and conditions
  Date: 2003
  Discusses disease management among rural African Americans.
• Diagnostic Risk Factors & Improvement Activities Among Rural Hispanics
  Research center: South Carolina Rural Health Research Center
  Topics: Chronic diseases and conditions, Hispanics
  Date: 2003
  Discusses disease management among rural Hispanics.

2002

• Hypertension, Diabetes, Cholesterol, Weight, and Weight Control Activities Among Non Metro Minority Adults
  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
  Date: 12 / 2002
  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.
• Diabetes and the Rural Safety Net
  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
  Date: 01 / 2002
  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.

2001

• Improving the Quality of Outpatient Care for Older Patients with Diabetes: Lessons from a Comparison of Rural and Urban Communities
  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
  Date: 08 / 2001
  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.

2000

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