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Rural Health
Research Gateway

ETSU/NORC Rural Health Research Center

Current Projects

  • Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Pre-COVID-19 and During COVID-19
    This study describes and compares the differences in the utilization of emergency department (ED) services among rural and urban Medicare Fee-For-Service enrollees during 2018-2021. We will identify factors associated with differences in ED use, including shifts in volume, primary diagnoses, and admission source, before and since the COVID-19 public health emergency in rural and urban areas.
    Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicare, Social determinants of health
  • Hierarchical Condition Category (HCC) Risk Scores: Designed to Predict Future Cost and Health Care Resource Use – Do They Also Accurately Reflect Differences in Health Status between Rural and Urban Beneficiaries?
    This CMS Hierarchical Condition Category (CMS-HCC) risk score study will investigate differences in underlying health between rural and urban populations using recent data and analyze which factors drive observed differences.
    Topics: Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA)
  • Screening, Brief Intervention and Referral to Treatment (SBIRT) Penetration in Rural vs. Urban Healthcare Settings in the U.S.
    This study will include an analysis of 2018/2019 Medicare, Medicaid and Commercial claims to compare the penetration of Screening, Brief Intervention and Referral to Treatment (SBIRT) and its different components in rural compared to urban healthcare settings. Within the overarching analysis, the study team will examine the type of interventions conducted within the SBIRT framework stratified by provider type, healthcare setting, and rural and urban provider ZIP codes. Findings will be analyzed within the context of county-level substance use rates, historical enactment of state SBIRT billing codes, overdoses, and alcohol poisoning-based hospital admissions contrasting trends in SBIRT administration with a proxy for community need.
    Topics: Chronic diseases and conditions, Health promotion and disease prevention, Medicaid and CHIP, Medicare, Mental and behavioral health, Private health insurance, Public health, Substance use and treatment
  • Suicide Mortality: A Comparison of Urban and Rural Rates
    Suicide contributes to significant mortality in the United States. This project will examine the differences in suicide rates by geography and explore its driving factors among urban and rural areas in the United States from 2018 to 2021. The research design of this study will adopt a cross-sectional, retrospective approach, using secondary data.
    Topics: Healthcare access, Mental and behavioral health, Public health, Rural statistics and demographics, Uninsured and underinsured