Laura-Mae Baldwin, MD, MPH

Phone: 206.685.4799
Email: lmb@fammed.washington.edu

WWAMI Rural Health Research Center
University of Washington
Department of Family Medicine
Box 354696
Seattle, WA 98195-4696

Completed Projects - (9)
Publications - (22)

Completed Projects - (9)

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.
Research center: WWAMI Rural Health Research Center
Topics: Aging, Cancer, Chronic diseases and conditions, Health services, Medicare, Minority health
Availability of Specialty Health Care for Rural American Indians and Alaska Natives
Research center: WWAMI Rural Health Research Center
Topics: American Indians and Alaska Natives, Health services, Minority health
Do Rural Patients with Early Stage Prostate Cancer Gain Access to All Treatment Choices?
This research will use cancer registry data from 10 states to examine the degree to which rural residents diagnosed with early stage prostate cancer access the full range of surveillance, surgical, and radiation treatment options. Study findings will inform cancer centers, advocacy groups, rural program planners, and policymakers about services and programs needed to ensure that rural prostate cancer patients can choose from among all treatment options.
Research center: WWAMI Rural Health Research Center
Topics: Cancer, Chronic diseases and conditions, Health services
Improvement in the Quality of Care for Acute Myocardial Infarction (AMI): Have Rural Hospitals Followed National Trends?
This project will determine whether overall improvements in the quality of care for AMI among Medicare patients, as measured by adherence to guidelines, have taken place in both rural and urban hospital settings.
Research center: WWAMI Rural Health Research Center
Topics: Hospitals and clinics, Quality
National Study of Rural-Urban Differences in Use of Home Oxygen for Chronic Obstructive Lung Disease: Are Rural Medicare Beneficiaries Disadvantaged?
To understand disparities in care among rural and urban Medicare beneficiaries, data from Medicare's Durable Medical Equipment (DME) files were used to assess rural/urban variation in the home use of supplemental oxygen.
Research center: WWAMI Rural Health Research Center
Topics: Chronic diseases and conditions, Medicare
National Trends in the Perinatal and Infant Health Care of Rural and Urban American Indians (AIs) and Alaska Natives (ANs)
This project examined and compared trends in prenatal care and mortality rates of rural and urban AI/AN and non-AI/AN populations in order to determine the level of disparity between these populations and their temporal changes.
Research center: WWAMI Rural Health Research Center
Topics: American Indians and Alaska Natives, Children and adolescents, Health disparities and health equity, Maternal health, Minority health
Perinatal Health in the Rural United States, 2005
This study examines perinatal outcomes in rural areas across the United States in 2005.
Research center: WWAMI Rural Health Research Center
Topics: Children and adolescents, Health disparities and health equity, Women
Quality of Care for Acute Myocardial Infarction Patients in U.S. Rural Hospitals
Research center: WWAMI Rural Health Research Center
Topics: Hospitals and clinics, Quality
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.
Research center: WWAMI Rural Health Research Center
Topics: Cancer, Chronic diseases and conditions, Health services

Publications - (22)

2014

Do Rural Patients With Early-Stage Prostate Cancer Gain Access to All Treatment Choices? (Final Report)
Report
WWAMI Rural Health Research Center
Date: 02/2014
This report compares rates of receipt of prostate cancer treatments and of the treatment options between early-stage prostate cancer patients living in urban and four levels of rural counties.

2013

Inadequate Prenatal Care Among Racial and Ethnic Groups in the Rural United States, 2005
WWAMI Rural Health Research Center
Date: 10/2013
This brief reports that in most states, rural minority racial/ethnic groups had levels of inadequate prenatal care (less than 50% of expected visits) in the "worst" or "worse than mid-range" categories.
Inadequate Prenatal Care in the Rural United States, 2005
WWAMI Rural Health Research Center
Date: 10/2013
This policy brief finds that the states with levels of rural inadequate prenatal care (less than 50% of expected visits) in the "worst" or "worse than mid-range" categories were largely in southern and southwestern areas of the United States.
Low Birth Weight Rates Among Racial and Ethnic Groups in the Rural United States, 2005
WWAMI Rural Health Research Center
Date: 10/2013
Reports that non-hispanic blacks generally had the highest rural low birth weight rates of all races/ethnicities, regardless of geographic location.
Low Birth Weight Rates in the Rural United States, 2005
WWAMI Rural Health Research Center
Date: 10/2013
This brief shares that the rural U.S. low birth weight rate in 2005 was significantly higher than the urban U.S. low birth weight rate.

2012

Receipt of Recommended Radiation Therapy Among Rural and Urban Cancer Patients (Summary)
WWAMI Rural Health Research Center
Date: 10/2012
This study examines whether rural patients with cancer are less likely than their urban counterparts to receive recommended radiation therapy. The study also identifies factors influencing rural versus urban differences in radiation therapy receipt.

2010

Quality of Care for Acute Myocardial Infarction: Are the Gaps Between Rural and Urban Hospitals Closing?
Policy Brief
WWAMI Rural Health Research Center
Date: 03/2010
Overall, there has been improvement in acute myocardial infarction quality measures and persistent rural-urban disparities in only a few. Particularly in small/remote small rural locations, developing strategies to increase use of beneficial discharge medications is important.
Quality of Care for Acute Myocardial Infarction: Are the Gaps Between Rural and Urban Hospitals Closing? (Final Report)
WWAMI Rural Health Research Center
Date: 03/2010
In the mid-1990s, quality of care for acute myocardial infarction (AMI) lagged in rural hospitals, with patients in the smallest and remotest hospitals at greatest risk. Overall quality of AMI care has improved in the United States since that time. Whether these improvements have been consistent across rural and urban hospitals is unknown.
Quality of Care for Myocardial Infarction in Rural and Urban Hospitals
Journal Article
WWAMI Rural Health Research Center
Date: 2010
In the mid-1990s, significant gaps existed in the quality of acute myocardial infarction (AMI) care between rural and urban hospitals. Since then, overall AMI care quality has improved. This study uses more recent data to determine whether rural-urban AMI quality gaps have persisted.

2009

Trends in Perinatal and Infant Health Disparities Between Rural American Indians and Alaska Natives and Rural Whites
Journal Article
WWAMI Rural Health Research Center
Date: 04/2009
Examines perinatal care, birth outcomes, and infant health between rural American Indian and Alaska Native (AIAN) persons and rural Whites over time. Despite significant decreases in inadequate prenatal care and postneonatal death among American Indians and Alaska Natives, additional measures are needed to close health gaps for this group.

2008

Access to Specialty Health Care for Rural American Indians in Two States
Journal Article
WWAMI Rural Health Research Center
Date: 06/2008
Examines access to specialty services among rural Indian populations in Montana and New Mexico, based on a survey sent to primary care providers addressing access to specialty physicians, perceived barriers to access, and access to nonphysician clinical services.
National Trends in the Perinatal and Infant Health of Rural American Indians (AIs) and Alaska Natives (ANs): Have the Disparities Between AI/ANs and Whites Narrowed? (Final Report)
WWAMI Rural Health Research Center
Date: 06/2008
This study examines whether disparities in perinatal care and birth outcomes between rural American Indians and Alaska Natives and whites diminished during a period of policy and funding changes in maternal/child health.
Access to Cancer Services for Rural Colorectal Cancer Patients
Journal Article
WWAMI Rural Health Research Center
Date: 2008
Includes findings from a study to determine how far rural and urban colorectal cancer (CRC) patients travel to three types of specialty cancer care services-surgery, medical oncology consultation, and radiation oncology consultation.

2006

Modeling the Mental Health Workforce in Washington State: Using State Licensing Data to Examine Provider Supply in Rural and Urban Areas
Journal Article
WWAMI Rural Health Research Center
Date: 2006
Identifies mental health shortage areas using existing licensing and survey data. Shortages of mental health providers exist throughout the state, especially in rural areas. Urban areas had 3x the psychiatrist full-time equivalents (FTEs) per 100,000 and more than 1.5x the nonpsychiatrist mental health provider FTEs per 100,000 as rural areas.

2005

Explaining Black-White Differences in Receipt of Recommended Colon Cancer Treatment
Journal Article
WWAMI Rural Health Research Center
Date: 2005

Black-white disparities exist in receipt of recommended medical care, including colorectal cancer treatment. This retrospective cohort study examines the degree to which health systems (e.g., physician, hospital) factors explain black-white disparities in colon cancer care. Black and white Medicare-insured colon cancer patients have an equal opportunity to learn about adjuvant chemotherapy from a medical oncologist but do not receive chemotherapy equally. Little disparity was explained by health systems; more was explained by illness severity, social support, and environment. Further qualitative research is needed to understand the factors that influence the lower receipt of chemotherapy by black patients.

2004

American Indians and Alaska Natives: How Do They Find Their Path to Medical School?
WWAMI Rural Health Research Center
Date: 01/2004
This paper describes the findings of a study to understand the paths of American Indian and Alaska Native students who successfully entered medical school.
Quality of Care for Acute Myocardial Infarction in Rural and Urban U.S. Hospitals
Journal Article
WWAMI Rural Health Research Center
Date: 2004
Acute myocardial infarction (AMI) is a common and important cause of admission to rural hospitals, as transport of patients with AMI to urban settings can result in unacceptable delays in care. This study examines the quality of care for patients with AMI in rural hospitals with differing degrees of remoteness from urban centers.

2002

Perinatal and Infant Health Among Rural and Urban American Indians/Alaska Natives
Journal Article
WWAMI Rural Health Research Center
Date: 09/2002
Provides a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health.

2001

Improving the Quality of Outpatient Care for Older Patients With Diabetes: Lessons From a Comparison of Rural and Urban Communities
Journal Article
WWAMI Rural Health Research Center
Date: 08/2001
Compares the quality of diabetic care received by patients in rural and urban communities in Washington State. Concludes that large rural towns may provide the best conditions for high-quality care-growing communities that serve as regional referral centers and have an adequate, but not excessive, supply of generalist and specialist physicians.
Gender-Related Factors in the Recruitment of Generalist Physicians to the Rural Northwest
WWAMI Rural Health Research Center
Date: 02/2001
This paper examines differences in the factors female and male generalist physicians considered influential in their rural practice location choice and identifies the practice arrangements that attracted female generalist physicians to rural areas.

2000

Emergency Department Use by the Rural Elderly
Journal Article
WWAMI Rural Health Research Center
Date: 2000
This study uses Medicare data to compare emergency department (ED) use by rural and urban elderly beneficiaries. Given the similarity of diagnostic conditions associated with ED visits, rural EDs must be capable of dealing with the same range of emergency conditions as urban EDs.

1999

Rural and Urban Physicians: Does the Content of Their Medicare Practices Differ?
Journal Article
WWAMI Rural Health Research Center
Date: 1999
Rural and urban areas have significant differences in the availability of medical technology, medical practice structures and patient populations. This study uses 1994 Medicare claims data to examine whether these differences are associated with variation in the content of practice between physicians practicing in rural and urban areas.