Rural Health Equity Research Center
A Closer Examination of Rural Hospital Bypass
This project will estimate the rural hospital bypass rate using all-payer claims data for a set of states and compare patients based on the inpatient treatments and procedures received relative to those routinely provided by rural facilities.
Topics: Critical Access Hospitals, Health reform, Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Minority health, Private health insurance, Uninsured and underinsured
Assessment of the Area Deprivation Index in Rural Areas
The Area Deprivation Index (ADI) was created by University of Wisconsin researchers to provide a score for neighborhoods based on their level of disadvantage. This study will characterize differences in ADI in rural vs urban areas, summarize the existing literature on ADI, and describe expert considerations for utilizing the ADI for future policy.
Topics: Frontier health, Health disparities and health equity, Poverty, Rural statistics and demographics, Social determinants of health
Characteristics of Buprenorphine Therapy Among Commercially-Insured Pregnant and Postpartum Women
This project will analyze claims from a national commercial insurance database to characterize buprenorphine therapy initiation persistence and adherence among pregnant and postpartum women with opioid use disorder (OUD) and assess differences in buprenorphine OUD treatment characteristics among rural and urban pregnant/postpartum women.
Topics: Health disparities and health equity, Healthcare access, Maternal health, Substance use and treatment
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, Emergency medical services and trauma, Health disparities and health equity, Healthcare access, Hospitals and clinics, Medicare, Social determinants of health
Examining the Burden of Public Stigma Associated with Mental Illness in the Rural U.S.
This project will quantitatively examine the burden of public stigma associated with mental illness in rural versus nonrural communities using a nationally representative panel-based survey. Findings will inform strategies aimed at reducing stigma and improving the lives of those experiencing mental illness in rural communities.
Topics: Health services, Mental and behavioral health
Following the Money: Do Block Grant Resources Reach Rural Communities?
This project will apply a mixed methods design to describe the distribution of block grant resources from federal agencies through states to the local level in rural and non-rural communities in the United States. Findings could guide federal agencies and policy makers to develop strategies to more effectively target block grant resources to ensure that the needs of vulnerable rural populations are addressed.
Topics: Health services, Healthcare financing, Public health, Rural statistics and demographics
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 disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA)
Inpatient Treatment Costs Associated with Substance Use Disorders
The purposes of this project are to examine the costs and characteristics of inpatient stays associated with substance use disorders and to examine whether there are systematic differences in these stays and costs for persons residing in rural areas compared to urban areas.
Topics: Health disparities and health equity, Healthcare access, Healthcare financing, Mental and behavioral health, Substance use and treatment
Rural-Urban Analysis of Persistent Health Professional Shortage Areas
The study will describe rural-urban differences in persistent Health Professional Shortage Area designations for primary care, mental health, and dental care between 2010 and 2020, including those located in persistent poverty and majority minority counties.
Topics: Healthcare access, Mental and behavioral health, Oral health, Workforce
Rural/Urban Differences in Forgoing Health Care during the COVID-19 Pandemic
Several surveys conducted during the COVID-19 pandemic showed that adults delayed or skipped healthcare services during the initial months of the COVID-19 pandemic. This study examines changes in healthcare utilization for primary and preventative care among rural and urban Medicare fee-for-service enrollees since the COVID-19 pandemic.
Topics: Aging, Care management, Chronic diseases and conditions, Coronavirus Disease 2019 (COVID-19), Diabetes, Health disparities and health equity, Health promotion and disease prevention, Health services, Medicare, Mental and behavioral health, Minority health, Telehealth
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
Understanding Rural Health Data Challenges through Analysis of Peer-Reviewed Publication Limitations
This project will quantify and characterize health data-related limitations commonly identified in published studies on rural health and ways in which researchers overcome these challenges. Findings will provide a rigorous description of rural health data challenges, which may be used by researchers, policymakers, and rural health data collectors to improve rural data and research using rural data.
Topic: Rural statistics and demographics