Rural Health
Research Gateway

Davis Patterson, PhD

Director, WWAMI Rural Health Research Center

Phone: 206.543.1892
Email: davisp@uw.edu

Department of Family Medicine
University of Washington
4311 Eleventh Ave NE, Suite 210
Seattle, WA 98105

Current Projects - (12)

  • Access to and Provision of Child and Youth Behavioral Health Services in the Rural and Urban U.S.
    The need for behavioral health treatment for youth has been exacerbated by the COVID-19 pandemic. Little is known about the availability of youth behavioral health providers in rural areas. This study will investigate who provides behavioral health services to youth, how equitably the workforce is distributed, and gaps in service availability.
    Research center: WWAMI Rural Health Research Center
    Topics: Allied health professionals, Children and adolescents, Health disparities and health equity, Health services, Healthcare access, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Workforce
  • Barriers and Facilitators to Providing Rural Clinical Training for Health Professions Students and Residents
    Scarce rural clinical training sites are the top barrier preventing medical schools, residencies, and nurse practitioner and physician assistant education programs, among other health professional training programs, from providing rural training to their students. This study aims to describe the barriers to offering rural clinical training and the potential solutions for establishing and sustaining interdisciplinary rural clinical training.
    Research center: WWAMI Rural Health Research Center
    Topics: Allied health professionals, Healthcare access, Nurses and nurse practitioners, Physician assistants, Physicians, Workforce
  • Comparing Utilization and Quality of Home Health Care Between Medicare Fee-for-Service and Medicare Advantage Beneficiaries by Rural-Urban Status
    This project examines differences in home health use and quality by enrollment in Medicare Fee-for-Service (FFS) versus Medicare Advantage (MA) plans. Findings will include information on rural-urban and intra-rural variation in home health care to inform policies on access, payment, and quality for Medicare FFS and MA plans.
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Allied health professionals, Health disparities and health equity, Health services, Healthcare access, Healthcare financing, Home health, Medicare, Medicare Advantage (MA), Post-acute care, Quality
  • Dentist Supply, Dental Care Utilization, and Oral Health Among Rural and Urban U.S. Residents: Exploring Changes in the Past 15 Years
    This project will describe the national supply of the rural and urban dental workforce and investigate whether rural adults, compared to urban adults, report lower dental care utilization, higher prevalence of dental disease or both. This study will also look at whether disparities in oral health care and supply have changed over the past 15 years.
    Research center: WWAMI Rural Health Research Center
    Topics: Allied health professionals, Health disparities and health equity, Health services, Healthcare access, Oral health, Workforce
  • Disparities in Family Physician Burnout Before and During the COVID-19 Pandemic
    High levels of burnout during the COVID-19 pandemic have been documented among health professionals, particularly women and persons from underrepresented groups. This study examines how burnout has changed from 2019 through 2021 among family physicians as well as variation by rural/urban geography, other sociodemographics, and practice characteristics to identify physicians most in need of interventions to foster resilience and alleviate burnout.
    Research center: WWAMI Rural Health Research Center
    Topics: Mental and behavioral health, Physicians, Workforce
  • Methamphetamine Use, Mental Health Comorbidities, and Treatment in Rural and Urban Areas
    This study will investigate methamphetamine (meth) use in rural versus urban areas - including meth use in combination with opioids and alcohol, mental health comorbidities, and perceived need for and receipt of treatment by meth users and those with meth use disorder - to identify hotspots for targeting of prevention and treatment resources.
    Research center: WWAMI Rural Health Research Center
    Topics: Mental and behavioral health, Substance use and treatment
  • Palliative Care in the Rural U.S.
    This project will describe the availability of palliative care services in rural hospitals and community settings using data from the American Hospital Association Annual Survey, interviews with palliative care providers, and a survey of rural hospitals without palliative care services.
    Research center: WWAMI Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospice and palliative care, Hospitals and clinics
  • Specialist Physicians in the Rural and Urban U.S.: Supply, Distribution, and Access
    This project will describe the geographic distribution (rural/urban, regional, and intra-rural) of specialist physicians who care for patients experiencing conditions that account for the top four leading causes of rural mortality. It will also explore how patients in rural communities that lack these specialists obtain needed care.
    Research center: WWAMI Rural Health Research Center
    Topics: Cancer, Care management, Chronic diseases and conditions, Frontier health, Health disparities and health equity, Health services, Healthcare access, Physicians, Social determinants of health, Telehealth, Workforce
  • The Impact of Rural Surgery Training on General Surgeon Supply in Rural Communities
    A growing number of general surgery programs offer rural training that aims to address the dwindling supply of rural surgeons. This study aims to describe program models for providing rural general surgery training; quantify the availability of programs; and compare the models' effectiveness in producing rural surgeons.
    Research center: WWAMI Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Physicians, Workforce
  • Treatment, Provider, and Cost Differences for Rural and Urban Patients with Opioid Use Disorder Across the U.S.
    This study describes and compares the treatment that rural and urban patients with opioid use disorder (OUD) receive, documenting the workforce providing care, distance that patients travel to receive care, and cost of care. Findings will inform policies to ensure that rural patients with OUD have access to care from local healthcare providers.
    Research center: WWAMI Rural Health Research Center
    Topics: Health services, Healthcare access, Healthcare financing, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Telehealth
  • Treatment, Provider, and Cost Differences for Rural and Urban Patients with Opioid Use Disorder and Medicaid Insurance Across the U.S.
    This project will analyze Medicaid claims data to compare the treatment that rural and urban patients with opioid use disorder receive, documenting the workforce providing care, the distance that patients travel to receive care, and the cost of care. Findings from this study can be used to improve policies regarding opioid use disorder treatment.
    Research center: WWAMI Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Healthcare financing, Legislation and regulation, Medicaid and CHIP, Mental and behavioral health, Nurses and nurse practitioners, Pharmacy and prescription drugs, Physician assistants, Physicians, Substance use and treatment, Telehealth, Workforce
  • Trends in Health Workforce Supply in the Rural U.S.
    Rural communities in the U.S. have struggled to recruit and sustain sufficient health professionals to ensure adequate access to care. This study uses multiple sources of data to describe the geographic distribution (rural/urban, regional, and intra-rural) of numerous types of health professionals.
    Research center: WWAMI Rural Health Research Center
    Topics: Allied health professionals, Healthcare access, Mental and behavioral health, Nurses and nurse practitioners, Oral health, Physician assistants, Physicians

Completed Projects - (10)

  • Family Medicine Rural Training Track Graduates: Determinants of Rural and Urban Practice
    This project will survey physicians trained in "1-2" Rural Training Track (RTT) family medicine residencies to understand the characteristics, experiences, and attitudes that influenced their rural or urban practice choices.
    Research center: WWAMI Rural Health Research Center
    Topic: Workforce
  • Influence of State Policies and Practices on J-1 Visa Waiver Physicians Service in Rural Areas
    This study will collect information from all states regarding their efforts to track IMG practice after their Conrad 30 program waiver obligations are satisfied, quantify long-term retention for states with available data, and assess how state policies shape IMG practice and long-term retention.
    Research center: WWAMI Rural Health Research Center
    Topics: International Medical Graduates (IMGs), Physicians, Workforce
  • Novel Master File of Rural Family Medicine Residency Training: Program Models and Graduate Outcomes
    This study expands current work by the WWAMI RHRC to establish a comprehensive database of rural-focused family medicine residency training programs. We will use this database to (1) create a typology of rural-focused family medicine training and (2) evaluate program graduates' outcomes and the success of different program models.
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Workforce
  • 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.
    Research center: WWAMI Rural Health Research Center
    Topics: Healthcare access, Maternal health, Physicians, Women, Workforce
  • Pre-hospital Emergency Medical Services Personnel in Rural and Urban Areas: Results from a Survey in Nine States
    This study uses a survey of all ground-based pre-hospital emergency medical services (EMS) agencies in nine states (AR, FL, KS, MA, MT, NM, OR, SC, WI) to examine supply and demand for emergency response personnel, the involvement of medical directors, and the availability of medical consultation, in rural and urban agencies.
    Research center: WWAMI Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Workforce
  • Prehospital Emergency Medical Services Personnel: Comparing Rural and Urban Provider Experience and Provision of Evidence-based Care
    This study described 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.
    Research center: WWAMI Rural Health Research Center
    Topics: Allied health professionals, Emergency medical services (EMS) and trauma, Health services, Workforce
  • Rural Training Track Technical Assistance Program
    This project looks into the Rural Training Track Technical Assistance (RTT-TA) Program which is a recognized model for addressing rural primary care physician shortages. The WWAMI RHRC has led the research component to investigate RTT program characteristics, graduate outcomes, and factors affecting RTT sustainability and resilience.
    Research center: WWAMI Rural Health Research Center
    Topics: 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.
    Research center: WWAMI Rural Health Research Center
    Topics: Healthcare access, Maternal health, Physicians, 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 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.
    Research center: WWAMI Rural Health Research Center
    Topic: Physicians
  • What Is the Potential of Community Paramedicine to Fill Rural Healthcare Gaps?
    Community paramedicine (CP) has been promoted as a strategy to help communities achieve the Triple Aim of improving healthcare and population health while lowering costs. This study proposes to collect descriptive information on CP programs that can be identified in the U.S., and for those programs with outcome data, compare rural with urban programs in terms of their goals, services offered, outcomes measured, and results, where available.
    Research center: WWAMI Rural Health Research Center
    Topics: Allied health professionals, Emergency medical services (EMS) and trauma

Publications - (48)

2023

  • Understanding and Overcoming Barriers to Rural Training in Family Medicine Obstetrics Fellowships
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 06/2023
    This policy brief describes the results of a survey on the characteristics and challenges faced by rurally oriented family medicine obstetrics fellowship programs. All survey respondents reported their programs had a mission to train family physicians for rural practice, yet less than one-third of programs reported they required rural training.
  • Understanding and Overcoming Barriers to Rural Obstetric Training for Family Physicians
    Journal Article
    WWAMI Rural Health Research Center
    Date: 03/2023
    Family physicians are the most common health professional providing rural obstetric (OB) care, but the number of family physicians practicing OB is declining. This mixed-methods study aimed to inform policy and practice solutions to address the training landscape and inform sustainable initiatives for rural family medicine obstetrical training.

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2016

  • What Is the Potential of Community Paramedicine to Fill Rural Healthcare Gaps?
    Journal Article
    WWAMI Rural Health Research Center
    Date: 11/2016
    This study collected information on rural community paramedicine in the U.S. programs to describe their goals, target populations, services offered, connections with local community providers and resources, outcomes measured, and results, where available.
  • Community Factors and Outcomes of Home Health Care for High-Risk Rural Medicare Beneficiaries
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 10/2016
    Outcomes of care vary by region of the country for rural Medicare beneficiaries receiving home health services for high-risk conditions such as heart failure. Those in the East South Central and West South Central Census Divisions had lower rates of community discharge and higher rates of hospital readmission and emergency department use.
  • Do Residencies That Aim to Produce Rural Family Physicians Offer Relevant Training?
    Journal Article
    WWAMI Rural Health Research Center
    Date: 09/2016
    Examines the rural-centric family medicine residencies, their training locations, and rurally relevant skills training provided. Rural training can promote rural practice, but the number of family medicine residencies with a rural focus, geographic distribution of training, and training content are poorly understood.
  • Supply and Distribution of the Behavioral Health Workforce in Rural America
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 09/2016
    This brief uses National Provider Identifier (NPI) data to report on the variability of the supply and provider to population ratios of five types of behavioral health workforce providers (psychiatrists, psychologists, social workers, psychiatric nurse practitioners, counselors) in Metropolitan, Micropolitan and Non-core rural areas across the U.S.
  • Graduates of Rural-centric Family Medicine Residencies: Determinants of Rural and Urban Practice
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 07/2016
    This study of graduates of family medicine residencies seeking to produce rural physicians identified influences on rural practice choice, including significant others, residency, and practice communities. Findings point to the need to sustain the preferences of physicians interested in rural practice and encourage this interest in others.
  • Conrad 30 Waivers for Physicians on J-1 Visas: State Policies, Practices, and Perspectives
    Report
    WWAMI Rural Health Research Center
    Date: 03/2016
    States rely on international medical graduates (IMGs) to fill workforce gaps in rural and urban underserved areas. This study collected quantitative and qualitative information from states to assess how state policies and practices shape IMG recruitment and practice in underserved areas.
  • How Could Nurse Practitioners and Physician Assistants Be Deployed to Provide Rural Primary Care?
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 03/2016
    New (2014) rural enrollees in the insurance plans on federal and state exchanges are expected to generate about 1.39 million primary care visits per year. At a national level, it would require 345 full-time equivalent physicians to provide those visits. This study examines how different mixes of physicians, PAs, and NPs might meet the increase.
  • Outcomes of Rural-Centric Residency Training to Prepare Family Medicine Physicians for Rural Practice
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 03/2016
    Among those with eight or more weeks of rural training, no single program characteristic or model offered sustained advantages over any other type in producing high yields to rural practice.
  • Access to Rural Home Health Services: Views From the Field
    Report
    WWAMI Rural Health Research Center
    Date: 02/2016
    Access to home health care can be challenging for rural Medicare clients. Key informants for this study detailed obstacles, including financial, regulatory, workforce, and geographic issues. Rural communities will likely benefit from payment reforms that reward quality services while providing incentives to use best practices in home health care.
  • Family Medicine Rural Training Track Residencies: 2008-2015 Graduate Outcomes
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 02/2016
    This policy brief is the latest in a series tracking the rural practice outcomes of family physicians who have completed graduate medical education in Rural Training Track (RTT) residency programs.

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