WWAMI Rural Health Research Center

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2023

  • Overcoming Barriers to Providing Rural Obstetrical Training for Physicians
    Rural communities struggle to maintain obstetrical (OB) services, due in part to scarce rural training opportunities for obstetricians and family physicians. This study described the availability, characteristics, and output of residency and fellowship programs offering rural OB training and identified solutions to support this training.
    Topics: Healthcare access, Maternal health, Physicians, Women, Workforce

2022

2021

  • Do Rural Breast and Colorectal Cancer Patients Present at More Advanced Disease Stages than Their Urban Counterparts?
    Access to recommended cancer screening is more difficult for rural residents than their urban counterparts. This study used the Surveillance, Epidemiology and End Results Program (SEER) data to examine the extent to which rural residents present at more advanced disease stages for breast and colorectal cancer diagnosis than urban residents.
    Topics: Cancer, Health disparities and health equity, Health promotion and disease prevention, Health services
  • Geographic Access to Healthcare for Rural Medicare Beneficiaries: An Update and National Look
    This objective of this study was to compare, at a national and census division level, where rural and urban Medicare beneficiaries receive ambulatory care, which types of specialists they utilize and how far beneficiaries are traveling to obtain care.
    Topics: Aging, Chronic diseases and conditions, Health services, Medicare, Workforce
  • Post-acute Care Trajectories for Rural Medicare Beneficiaries
    Utilization and costs of post-acute care for Medicare fee-for-service beneficiaries have grown rapidly during the last decade. This study examined post-acute care utilization for rural Medicare beneficiaries following acute hospitalization, describing use of home health and skilled nursing care and trajectories of care across settings.
    Topics: Aging, Allied health professionals, Health services, Home health, Hospitals and clinics, Medicare, Nurses and nurse practitioners, Post-acute care
  • The Current Distribution of the General Surgery Workforce in Rural America
    This project described the current national supply and distribution of general surgeons in rural vs. urban areas of the United States as well as geographic variability in the supply of general surgeons across the rural/urban and intra-rural dimensions at the regional level.
    Topics: Critical Access Hospitals (CAHs), Health services, Healthcare access, Hospitals and clinics, Physicians, Rural statistics and demographics, Workforce
  • What Is the Geographic Distribution of the Workforce with a DEA Waiver to Prescribe Buprenorphine?
    This project updated statistics on the supply of providers (physicians, nurse practitioners and physician assistants) with a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine and examine supply trends over time and also established baseline numbers of other eligible providers (e.g., midwives, clinical nurse specialists).
    Topics: Health services, Healthcare access, Mental and behavioral health, Nurses and nurse practitioners, Physician assistants, Physicians, Substance use and treatment, Workforce

2020

  • Assessing Potential Unmet Need for Home Healthcare in Rural Areas
    This study estimated potential unmet need for home healthcare in rural areas for fee-for-service Medicare beneficiaries. We compared rates of home healthcare utilization in rural areas with urban areas, accounting for acute hospital discharges and utilization of inpatient rehabilitation facilities and skilled nursing facilities.
    Topics: Health services, Home health, Hospitals and clinics, Medicare, Post-acute care
  • The Supply and Distribution of the Primary Care Health Workforce in Rural America
    This study will describe the supply and distribution of primary care providers in the rural U.S. at national, regional, and state levels using the most recent data available. Primary care health professionals include family physicians, general practitioners, general internists, pediatricians, nurse practitioners, and physician assistants.
    Topics: Nurses and nurse practitioners, Physician assistants, Physicians, Workforce
  • The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S.
    This project will use multiple data sources to characterize the distribution of the obstetrical care workforce in the U.S., comparing health professional-to-population ratios in rural and urban areas. Health professionals examined in this study include obstetricians, family physicians, and certified nurse midwives.
    Topics: Healthcare access, Maternal health, Physicians, Workforce
  • Who Provides Mental Health Services to Rural Medicare Beneficiaries?
    Most rural counties do not have a psychiatrist to care for the common conditions of depression or anxiety. This study describes the provider workforce that cares for rural elderly patients with depression/anxiety, including regional and rural-urban variations in mental healthcare provision.
    Topics: Health services, Medicare, Mental and behavioral health, Nurses and nurse practitioners, Physician assistants, Physicians, Substance use and treatment, Workforce

2019

  • Diverging Populations Served by the Medicare Home Health Benefit: Comparison of Post-acute vs. Community-entry Home Health in Rural Areas
    This study examined differences between rural, fee-for-service Medicare beneficiaries who were admitted to home health from the community (community-entry) and those who were admitted to home health following an inpatient stay (post-acute) in terms of their clinical and non-clinical characteristics as well as the communities in which they live.
    Topics: Health services, Home health, Medicare, Post-acute care
  • Understanding the Prescribing Practices of Rural Nurse Practitioners and Physician Assistants with a DEA Waiver to Prescribe Buprenorphine
    This study investigated the extent to which nurse practitioners and physician assistants who practice in rural areas and have a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine as an office-based outpatient treatment for opioid use disorder are providing this treatment to their patients.
    Topics: Nurses and nurse practitioners, Physician assistants, Substance use and treatment
  • What Impact Will Unified GME Accreditation Have on Rural-focused Physician Residencies
    The impending unification of allopathic and osteopathic graduate medical education (GME) under a single accreditation system has uncertain implications for small and rural-focused residency programs. This study aimed to (1) quantify the rural practice outcomes of residencies in rurally-relevant specialties such as pediatrics, internal medicine, obstetrics/gynecology, emergency medicine, surgery, anesthesia, and psychiatry, and (2) interview key stakeholders to identify anticipated challenges of the accreditation merger and potential policies to strengthen vulnerable rural-focused residencies during the transition.
    Topic: Physicians

2018

2017

  • The Supply and Distribution of the Behavioral Health Workforce in Rural America
    Data from the National Plan and Provider Enumeration System (NPPES) file, linked to RUCA codes and population data will be used to identify behavioral health providers and describe their geographic (rural/urban, regional and intra-rural) distribution. Behavioral health professions identified in the file include psychiatrists, addiction medicine specialists, psychiatric nurse practitioners, clinical nurse specialists in mental health, clinical psychologists and licensed social workers.
    Topics: Allied health professionals, Mental and behavioral health, Workforce
  • Who Treats Opioid Addiction in Rural America? Quantifying the Availability of Buprenorphine Services in Rural Areas
    This study will investigate the extent to which physicians who practice in rural areas and have a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine as an office-based outpatient treatment for opioid use disorder are providing this treatment to their patients. This study will also estimate the need for office-based opioid disorder treatment in rural locations.
    Topics: Chronic diseases and conditions, Mental and behavioral health, Pharmacy and prescription drugs, Substance use and treatment

2016

2015

2014

  • Health Information Technology (HIT) Workforce Needs in Rural America
    Health care increasingly relies on effective health information technology (HIT) to capture and exchange key patient information, and requires a trained workforce to implement this technology. To understand the specific needs and constraints of rural health systems to employ an effective HIT workforce, this study will survey rural primary care clinics across the country to determine their current and projected level of HIT adoption and demand for workers with HIT skills.
    Topics: Health information technology, Workforce
  • Supply of Physicians Waivered to Treat Opioid Addiction in Rural America: Policy Options to Remedy Critical Shortages
    This study will determine the extent to which a trained workforce exists in rural America that has received the necessary waiver to treat opioid addiction in outpatient settings with buprenorphine, a highly effective medication. It will identify areas with critical shortages and discuss policy options for expanding the supply of these qualified providers.
    Topics: Physicians, Substance use and treatment, Workforce
  • What Strategies Are Nurse Practitioner Educational Programs Using to Encourage Rural Practice?
    This study will quantify and describe nurse practitioner (NP) education programs that encourage NPs to practice in rural areas, and identify data sources that could be used in future studies of the effectiveness of these programs.
    Topics: Nurses and nurse practitioners, Physician assistants, Workforce

2013

2012

  • Community College's Contributions to the Education of Allied Health Professionals in Rural Areas of the U.S.
    This study will identify rural-serving community colleges across the U.S. and their 5-year graduation trends for specific allied health professions, examine the spectrum of how rural allied health professions education currently is being allocated and delivered, and explore how community economic status and estimated regional allied health workforce demand is associated with the availability of rural community college allied health education programs.
    Topics: Allied health professionals, Workforce
  • Factors Associated with Rural-Residing Registered Nurses' Choices to Work in Urban Locations and Larger Rural Cities
    While larger numbers of registered nurses (RNs) are living in rural areas, research from the WWAMI RHRC shows that since 1980, a growing percentage are commuting from rural residences to work within urban and larger rural cities. This study will explore factors that may be associated with RNs' decisions to commute away from their rural areas of residence to work in less rural areas.
    Topics: Nurses and nurse practitioners, Physician assistants, Workforce
  • Use of Recommended Radiation Therapy in the Rural U.S.
    This study will use cancer registry data from 10 U.S. states to examine which rural cancer patients are receiving recommended radiation therapy, and what factors influence receipt of recommended treatment. Identifying gaps in radiation therapy will inform cancer centers, rural program planners, and policy makers in rural cancer service locations and cancer support program development.
    Topics: Cancer, Chronic diseases and conditions, Health services

2010

2009

2008

  • Changes in U.S. Rural Perinatal and Infant Health Care During the Last Decade
    This study examined changes in rates of adverse birth outcomes and prenatal care among rural Americans of different racial and ethnic groups during two time periods. The study used national data from the Linked Birth Death Data Sets to assess differences in low birth weight, neonatal death, post neonatal mortality and inadequate prenatal care.
    Topics: Children and adolescents, Health disparities and health equity, Maternal health
  • Long Term Trends in Characteristics of the Rural Nurse Workforce: A National Health Workforce Study
    This national study characterizes changes in the demographic, education and practice characteristics of registered nurses (RNs) in rural and urban areas from 1980 to 2004. This study provides important information for projecting future trends in rural RN supply.
    Topics: Nurses and nurse practitioners, Physician assistants, Workforce
  • National Changes in Physician Supply
    This project describes the supply of allopathic and osteopathic physicians in rural and urban areas of the US. Study results will provide a current picture of rural physician supply and its variation by state and by region.
    Topics: International Medical Graduates (IMGs), Physicians, Workforce

2007

2006

  • Rural Health Center Expansion and Recruitment Survey
    This collaborative project between WWAMI and the South Carolina Rural Health Research Centers examined and described the current staffing needs of rural health centers (RHCs), ascertained the staffing, recruitment, and retention issues that RHC CEOs regard as most critical; distinguished how issues differ between CEOs contemplating development of expansion sites versus those who are not; and described how these findings correlate with the literature and current national supply projections for the categories of health professions needed by the RHCs.
    Topics: Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Workforce

2005

2004

2003

2002

2000

1999

Unknown

  • Access to Cancer Services for Rural Colorectal Cancer Medicare Patients: A Multi-State Study
    This study examined a comprehensive database to quantify the distance and access to four types of cancer services in a sample of rural, Medicare-insured, CRC patients of different racial and ethnic groups, and will inform future work designed to understand discrepancies in cancer service use by the rural elderly in different racial and ethnic groups.
    Topics: Aging, Cancer, Chronic diseases and conditions, Health services, Medicare, Minority health
  • The Rural/Urban Practice Location Patterns of Women Medical School Graduates
    While women are becoming an increasingly large percentage of the graduates of medical schools, they are much less likely to locate their practices in rural towns. This study involved a survey including questions about where the residents preferred to locate and how much they thought they would be practicing in the future.
    Topics: Physicians, Women, Workforce