WWAMI Rural Health Research Center
Assessing Potential Unmet Need for Home Healthcare in Rural Areas
This study will estimate potential unmet need for home healthcare in rural areas for fee-for-service Medicare beneficiaries. We will compare 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
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 uses 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 is 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
Increasing the Supply of Providers with a Drug Enforcement Agency Waiver to Treat Opioid Addiction in Rural America – Possible Effects of Permitting Physician Assistants and Nurse Practitioners to Prescribe Buprenorphine
This study will investigate the possible effects on rural access to treatment for opioid use disorder if Drug Enforcement Administration (DEA) waivers to prescribe buprenorphine as an office-based outpatient treatment for opioid addiction are available to Physician Assistants (PAs) and Nurse Practitioners (NPs).
Topics: Legislation and regulation, Nurses and nurse practitioners, Physician assistants, Physicians, Substance use and treatment, Workforce
International Medical Graduates on J-1 and H-1B Visas: Understanding Trends in their Contributions to Health Care Delivery for Rural Underserved Populations
This study will identify trends and data needs regarding the contributions of international medical graduates' on J-1 and H-1B visas (IMGs) to rural health care delivery. A workgroup of IMG research and policy stakeholders will be established to help identify IMG supply data trends, needs, and pressing policy issues, lay the groundwork for potential areas of study, data integration and data collection, as well as strengthen the policy-relevance of our work.
Topic: International Medical Graduates (IMGs)
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 will examine 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
Prehospital Emergency Medical Services Personnel: Comparing Rural and Urban Provider Experience and Provision of Evidence-based Care
This study will describe the relationship between prehospital emergency medical services (EMS) providers’ accumulated experience and provision of evidence-based care for rural and urban populations using newly available data on EMS agencies, personnel, and patient care.
Topics: Allied health professionals, Emergency medical services and trauma, Health services, Workforce
Use of Home Health Services among High Risk Rural Medicare Patients: Patient, Service, and Community Factors Associated with Outcomes of Care
This study will examine outcomes of care for rural Medicare patients who were discharged from hospitals and admitted to home healthcare for post-acute services. Outcomes will include emergent care use and re-hospitalization during the home health admission and community discharge.
Topics: Health services, Home health, Medicare, Post-acute care
What Are Best Practices for Providing Buprenorphine Maintenance Treatment in Rural Primary Care?
Not all physicians with a Drug Enforcement Agency waiver to prescribe buprenorphine actually provide this treatment or fully utilize their waiver capacity. This project will interview physicians successfully using their waivers to identify best practices for prescribing buprenorphine treatment for Opioid Use Disorder.
Topics: Health services, Mental and behavioral health, Physicians, Substance use and treatment, Workforce
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 proposed study aims 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.
What Makes Physician Assistant Programs Successful at Training Rural PAs?
A current WWAMI RHRC study has identified the physician assistant (PA ) training programs that have reduced high numbers and high proportions of graduates working in rural areas. The proposed study will extend that work through a physician assistant program survey, identifying key characteristics, admission, and training strategies, and missions of successful rural programs.
Topics: Physician assistants, 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 will describe 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