Peiyin Hung, PhD, MSPH

Deputy Director, Rural and Minority Health Research Center

Phone: 803.777.9867
Email: hungp@mailbox.sc.edu
X: @PeiyinHung

University of South Carolina
220 Stoneridge Drive, Suite 204
Columbia, SC 29210

Current Projects - (5)
Completed Projects - (3)
Publications - (55)

Current Projects - (5)

Availability of Diabetes Self-Management Education in High Need Rural Counties
This project will examine the degree to which counties with a high need for diabetes education, defined by high diabetes prevalence, have such education available. Findings will be linked to a related study that will examine the availability of dialysis for end stage renal disease, a severe outcome of poorly addressed diabetes.
Research center: Rural and Minority Health Research Center
Topics: Diabetes, Health services
Challenges, Successes, and Sustainability of the 2019 Rural Maternity and Obstetrics Management Strategies (RMOMS) Programs
This mixed-methods study aims to understand awardees' experiences in building and maintaining cohesive networks for Rural Maternity and Obstetrics Management Strategies (RMOMS).
Research center: Rural and Minority Health Research Center
Topics: Health disparities and health equity, Health services, Healthcare access, Maternal health, Minority health, Networking and collaboration, Telehealth, Women
Changes in Medicare Fee-for-Services Health Care Expenditures in Rural and Urban Communities after Passage of the Affordable Care Act
This project will assess changes in Medicare per-beneficiary spending across rural and urban counties from 2007 to 2020. It will examine differences in rural versus urban per-beneficiary spending on hospital inpatient, hospital outpatient, physician, and post-acute care after the Affordable Care Act (ACA).
Research center: Rural and Minority Health Research Center
Topics: Care management, Chronic diseases and conditions, Health disparities and health equity, Health services, Hospitals and clinics, Public health
Disparities in Mental Health Services Access: the Intersectionality of Residence Rurality, Race, and Ethnicity
In 2021, approximately 8.6 million rural adults faced mental health challenges while millions of rural adolescents battled major depressive episodes. This study examines disparities in mental health services uptake and variation in mental health care settings across racial-ethnic and rural-urban subpopulations before and after the COVID-19 pandemic.
Research center: Rural and Minority Health Research Center
Topics: Children and adolescents, Coronavirus Disease 2019 (COVID-19), Health services, Healthcare access, Mental and behavioral health
Rural-Urban Disparities in Mental Health Access and Quality in the United States
The purpose of this project is to document the recent trends of mental health care access and quality in urban and rural communities and to assess the intersectionality of residence rurality and race/ethnicity on disparities in mental health care access and quality.
Research center: Rural and Minority Health Research Center
Topics: Health disparities and health equity, Healthcare access, Mental and behavioral health

Completed Projects - (3)

Availability and Quality of Dialysis in Rural Counties with a High Diabetes Burden
This project examined the degree to which counties with a high population risk for end stage renal disease, defined by high diabetes prevalence, are served by dialysis providers. It assessed the accessibility and quality of services for end stage renal disease looking for disparities associated with rural residence and racial/ethnic population composition.
Research center: Rural and Minority Health Research Center
Topics: Diabetes, Health disparities and health equity, Health services, Public health, Quality
Cancer Prevention and Control Activities in Rural Hospitals
This project aimed to understand how rural hospitals perceive and implement evidence-based cancer screening and treatment and related intervention strategies.
Research center: Rural and Minority Health Research Center
Topics: Cancer, Hospitals and clinics, Minority health
Examining Rural-Urban Differences in Availability of Hospital Cardiac Testing Services Between 2010-2020
This project will examine whether the availability of hospital-based cardiac testing services has changed over the past ten years in rural and urban counties and identify the characteristics of counties where service availability has changed.
Research center: Rural and Minority Health Research Center
Topics: Care management, Chronic diseases and conditions, Health disparities and health equity, Health services, Hospitals and clinics, Public health

Publications - (55)

2024

Availability and Quality of Dialysis Care in Rural Versus Urban U.S. Counties
Journal Article
Rural and Minority Health Research Center
Date: 02/2024
An examination of rural-urban differences in quality of dialysis care offered across the United States was conducted using data from Medicare certified dialysis facilities in 2020 from the Centers for Medicaid and Medicare.

2023

Geographic Variations in Driving Time to U.S. Mental Health Care, Digital Access to Technology, & Household Crowdedness
Journal Article
Rural and Minority Health Research Center
Date: 12/2023
This study compared travel time to mental health facilities in rural versus urban areas and potential barriers to digital devices for telemedicine access in those same rural/urban locations. In addition, the research examined private space within the home as it relates to household crowdedness.
Assessing Key Indicators of Rural Versus Urban Water Quality
Policy Brief
Rural and Minority Health Research Center
Date: 08/2023
This study presents a summary of water quality monitoring data sources and models, identifies the gaps that persist, and proposes the salient categories and types of data that should be contained in a national water quality monitoring database to accurately describe rural water quality.
Availability of Dialysis Facilities in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2023
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. The brief looks at the availability of dialysis providers in minoritized racial/ethnic areas.
Availability of Primary Care Safety Net Providers in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2023
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at the distance to the nearest primary care safety net provider.
Examining Rural-Urban Differences in the Availability of Hospital-Based Cardiac Services Between 2010-2020
Policy Brief
Rural and Minority Health Research Center
Date: 08/2023
This study examines the availability of hospital-based cardiac health care services (general cardiology, diagnostic catheterization, and interventional catheterization) and whether rural-urban differences in the availability of these health care services occurred between 2010 and 2020.
Accommodation and Acceptability of Health Care by Non-Metropolitan/Metropolitan and Race/Ethnicity Status
Policy Brief
Rural and Minority Health Research Center
Date: 07/2023
This research examined rural-urban (i.e., non-metropolitan/metropolitan) differences in accommodation and acceptability of health care by operationalizing two survey questions from the health care access optional module of the Behavioral Risk Factor Surveillance System survey.
Access to Health Services Across Rural and Urban Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 03/2023
This brief summarizes selected results from a series of reports documenting disparities in geographic access to health services for rural and urban places that have a relatively high proportion of residents from minoritized racial and ethnic groups. "Areas" were examined at the ZIP Code Tabulation Area level.
Assessing Geographic Variability in Key Indicators of Air Quality: A Rural vs. Urban Comparison of Pollution and Socio-Economic Factors
Policy Brief
Rural and Minority Health Research Center
Date: 03/2023
The purpose of this study was to examine rates of air pollution between rural and urban census tracts. In addition, urban-rural disparities in exposure to polluted air across Environmental Protection Agency-defined regions were examined.
The COVID-19 Pandemic Impact on Independent and Provider-Based Rural Health Clinics' Operations and Cancer Prevention and Screening Provision in the United States
Journal Article
Rural and Minority Health Research Center
Date: 03/2023
The provision of Rural Health Clinic (RHC) cancer prevention and screening services was examined to identify any changes pre- and peri-pandemic. The research examined overall provision of cancer prevention and screening services by RHCs and the provision of these services by independent RHCs and by provider-based RHCs .
Variations in Affordability of Health Care by Non-Metropolitan/Metropolitan and Race/Ethnicity Status Across Eight Geographically Dispersed States
Policy Brief
Rural and Minority Health Research Center
Date: 01/2023
This research examined rural-urban (i.e., non-metropolitan/metropolitan) differences in affordability inclusive of insurance coverage and cost barriers. The research also examined forgoing medical care/medication and medical debt using Behavioral Risk Factor Surveillance System survey data from the healthcare access optional module.

2022

The Impact of the COVID-19 Pandemic on Rural Health Clinics' Operations and Cancer Prevention and Control Efforts
Policy Brief
Rural and Minority Health Research Center
Date: 11/2022
This study surveyed a stratified random sample of Rural Health Clinics throughout the country to examine how the pandemic has affected their overall operations and provision of cancer prevention and control services.
Rural-Urban Disparities in Quality of Inpatient Psychiatric Care
Journal Article
Rural and Minority Health Research Center
Date: 11/2022
Using data from the Inpatient Psychiatric Facility Quality Reporting program 2015-2019, this study examined differences and changes in the quality of inpatient psychiatric care in rural and urban hospitals.
Changes in Access to Nearest Federally Qualified Health Centers and Rural Health Clinics Among Rural ZIP Codes That Did and Did Not Experience a Hospital Closure, 2006-2018
Policy Brief
Rural and Minority Health Research Center
Date: 10/2022
This brief explores changes in geographic accessibility within rural ZIP codes throughout the U.S. to Federally Qualified Health Centers and Rural Health Clinics, between 2016 and 2018.
The Involvement of Rural Health Clinic Practitioners in Cancer Treatment Decisions and Survivorship Care
Policy Brief
Rural and Minority Health Research Center
Date: 10/2022
This study examined Rural Health Clinics' practitioner involvement in cancer treatment decisions, management of side effects, surveillance, and survivorship care.
Availability of Hospital-Based Cancer Services Before and After Rural Hospital Closure, 2008-2017
Journal Article
Rural and Minority Health Research Center
Date: 09/2022
Using American Hospital Association survey data from 2008 to 2017, the changes in access to cancer-related screening and treatment services were examined to determine the impact of hospital closures across hospital service areas.
Availability of Hospital-Based Emergency Department and Trauma Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of hospital-based emergency department and trauma services at the ZCTA level.
Availability of Substance Use Disorder Treatment in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at spatial availability and travel burden for substance use disorder care at the ZCTA level.
Availability of Pharmacies in Minoritized Racial/Ethnic Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at access to pharmacies.
Spatial Access to Hospital-based Obstetric Units in Minoritized Racial/Ethnic Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at spatial access to hospital-based obstetric units in minoritized racial/ethnic areas.
Changes in Access to Community Health Services Among Rural Areas Affected and Unaffected by Hospital Closures Between 2006 and 2018: A Comparative Interrupted Time Series Study
Journal Article
Rural and Minority Health Research Center
Date: 07/2022
In this article, investigators compared access to Federally Qualified Health Centers and Rural Health Clinics by those in rural areas affected versus those in rural areas unaffected by hospital closures.
Comparison of Cancer Treatment Services Across Hospitals
Fact Sheet
Rural and Minority Health Research Center
Date: 05/2022
This research compared the availability of comprehensive oncology, chemotherapy, and radiation therapy in Critical Access Hospitals and non-Critical Access Hospitals.
The Problem of the Color Line: Place, Race, and Access to Health Care in America
Journal Article
Rural and Minority Health Research Center
Date: 02/2022
Using ZIP Code Tabulation Area boundaries and associated rural-urban commuting area codes, urban and rural places with the largest share of minoritized racial and ethnic groups were identified. A StoryMap was then created to illustrate disparities experienced based on where Indigenous populations and people of color reside spatially.

2021

Changes in Socioeconomic Mix and Health Outcomes in Rural Counties With Hospital Closures, 2005-2018
Policy Brief
Rural and Minority Health Research Center
Date: 09/2021
This brief examines the trend of hospital closures between 2005 and 2018 across definitions of rurality. Social, economic, and health structure trends at the county level across the contiguous United States were the study's focus.
Trends in Cancer Treatment Service Availability Across Critical Access Hospitals and Prospective Payment System Hospitals
Journal Article
Rural and Minority Health Research Center
Date: 08/2021
This study investigated trends in cancer services availability in urban and rural Prospective Payment System (PPS) hospitals and Critical Access Hospitals (CAHs). Compared with all PPS hospitals, CAHs offered fewer cancer treatment services and experienced a decline in service capability over time.
Trends in Spatial Access to Colonoscopy in South Carolina, 2000-2014
Journal Article
Rural and Minority Health Research Center
Date: 06/2021
This study looks at the availability of colonoscopy screenings in South Carolina between 2000 and 2014 with a focus on changes in spatial access for these preventive services.
Rural and Racial Disparities in Colorectal Cancer Incidence and Mortality in South Carolina, 1996 - 2016
Journal Article
Rural and Minority Health Research Center
Date: 05/2021
This study investigated how race and rurality impact colorectal cancer incidence and mortality in South Carolina.

2020

Cervical Cancer Treatment Initiation and Survival: The Role of Residential Proximity to Cancer Care
Journal Article
Rural and Minority Health Research Center
Date: 10/2020
This study looked at the role drive time to cancer care facilities played on cancer treatment initiation and survival for cervical cancer patients.
Rural and Racial Disparities In Colorectal Cancer Incidence and Mortality In South Carolina 1996 - 2016 (Fact Sheet)
Fact Sheet
Rural and Minority Health Research Center
Date: 08/2020
This fact sheet examines the burden of colorectal cancer among South Carolina residents by urban-rural status and race/ethnicity.

2019

Geographic Disparities in Residential Proximity to Colorectal and Cervical Cancer Care Providers
Journal Article
Rural and Minority Health Research Center
Date: 11/2019
Persistent rural‐urban disparities for colorectal and cervical cancers raise concerns regarding access to treatment providers. To the authors knowledge, little is known regarding rural‐urban differences in residential proximity to cancer specialists.

2018

Rural-Urban Differences in Hospital Payer Mix in 2017
Fact Sheet
Rural and Minority Health Research Center
Date: 11/2018
This work revealed that rural hospitals heavily rely on Medicare.
Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2018
This study examines whether the loss of obstetric services in hospitals in rural U.S. counties led to changes in childbirth outcomes or locations.

2017

Access to Obstetric Services in Rural Counties Still Declining, With 9 Percent Losing Services, 2004-14
Journal Article
University of Minnesota Rural Health Research Center
Date: 09/2017
Providing access to obstetric care in rural areas is a growing concern. By 2014, about 54% of rural counties in the United States did not have hospital obstetric services.
Identifying Adverse Drug Events in Rural Hospitals: An Eight-State Study
Policy Brief
University of Minnesota Rural Health Research Center
Date: 05/2017
Analyzes the prevalence of Adverse Drug Events (ADEs) in rural hospitals, including both CAHs and rural PPS hospitals, related to four categories of drugs: steroids, antibiotics, opiates / narcotics, and anticoagulants in 2013 for eight states. It also examines whether or not these hospitals' ADE rates varied based on hospital characteristics.
Resources to Reduce Adverse Drug Events in Rural Hospitals
Policy Brief
University of Minnesota Rural Health Research Center
Date: 05/2017
This policy brief provides resources that could be used to decrease Adverse Drug Events (ADEs) in rural hospitals.
Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Counties
Policy Brief
University of Minnesota Rural Health Research Center
Date: 04/2017
This policy brief describes the scope of obstetric unit and hospital closures resulting in loss of obstetric services in rural U.S. counties from 2004 to 2014.
State Variability in Access to Hospital-Based Obstetric Services in Rural U.S. Counties
Policy Brief
University of Minnesota Rural Health Research Center
Date: 04/2017
This policy brief describes state-level variations in 1) the availability of hospital-based obstetric services, and 2) the scope of obstetric unit and hospital closures resulting in the loss of obstetric services in rural U.S. counties from 2004 to 2014.
Rural Hospital Employment of Physicians and Use of Cesareans and Nonindicated Labor Induction
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2017
Findings are shared from a study that discovered the types of doctors employed at rural hospitals may make a difference in the rates of cesarean births.

2016

Relationship Between Hospital Policies for Labor Induction and Cesarean Delivery and Perinatal Care Quality Among Rural U.S. Hospitals
Journal Article
University of Minnesota Rural Health Research Center
Date: 11/2016
This study focused on maternity care quality by taking a look at hospitals' policies regarding induced labor and Cesarean deliveries.
Why Are Obstetric Units in Rural Hospitals Closing Their Doors?
Journal Article
University of Minnesota Rural Health Research Center
Date: 08/2016
Analyzes the reasons behind hospital- and county-level factors for rural obstetric unit closures.
Factors Associated With High-Risk Rural Women Giving Birth in Non-NICU Hospital Settings
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2016
Identifies rick factors for childbirth in facilities without neonatal intensive care unit (NICU) capacities among high-risk rural women. The study found that rural women with preterm birthday and multiple gestation pregnancies were less likely to give birth in a hospital with NICU capacity if no local hospital had this capacity.
The Practice of Midwifery in Rural U.S. Hospitals
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2016
Analyzes the role of certified nurse-midwives (CNMs) in providing maternity care in rural US hospitals and to examine state-level variations on rural CNM practice. CNMs play an important role in the maternity care workforce in rural US hospitals.
Ensuring Access to High-Quality Maternity Care in Rural America
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2016
Examines the access to high-quality for rural women care during pregnancy and childbirth. Policy interventions at the local, state, and federal levels could help to address maternity care workforce shortages and improve quality of care available to the one-half million rural U.S. women who give birth each year.
Location of Childbirth for Rural Women: Implications for Maternal Levels of Care
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2016
This study looks into the rate at which rural women give birth at nonlocal hospitals. Approximately 75% of rural women gave birth at local hospitals. However, after controlling for clinical complications, rural Medicaid beneficiaries were less likely to give birth at nonlocal hospitals, implying a potential access challenge for this population.
State Variations in the Rural Obstetric Workforce
Policy Brief
University of Minnesota Rural Health Research Center
Date: 05/2016
Many types of staff are necessary to successfully run an obstetrics unit. Rural hospitals face unique staffing challenges. This policy brief describes the obstetric workforce in rural hospitals by state for nine states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin.
Rural Implications of Expanded Birth Volume Threshold for Reporting Perinatal Care Measures
Journal Article
University of Minnesota Rural Health Research Center
Date: 04/2016
In 2016 the minimum annual birth volume threshold for required reporting of the Joint Commission Perinatal Care measures by accredited hospitals decreased from 1,100 to 300 births. This study used the publicly available Join Commission Quality Check data from April 2014 to March 2015.

2015

Which Rural and Urban Hospitals Have Received Readmission Penalties Over Time?
Policy Brief
University of Minnesota Rural Health Research Center
Date: 10/2015
The Hospital Readmissions Reduction Program reduces Medicare payments for hospitals with excess rates of patient readmissions for certain conditions. It assesses rural/urban differences in the proportion of hospitals penalized under the program over time and whether condition-specific hospital readmission rates differ for rural/urban hospitals.
Rural Women Delivering Babies in Non-Local Hospitals: Differences by Rurality and Insurance Status
Policy Brief
University of Minnesota Rural Health Research Center
Date: 06/2015
This policy brief describes the extent to which rural pregnant women give birth in non-local hospitals and analyzes current patterns of non-local delivery by rural women's health insurance status and residential rurality.
Minimum Distance Requirements Could Harm High-Performing CAHs and Rural Communities
Journal Article
North Carolina Rural Health Research and Policy Analysis Center, University of Minnesota Rural Health Research Center
Date: 04/2015
Compares the effect of location on critical access hospitals' size, quality of care, and financial strength. Discusses implications of minimum distance requirements on critical access hospitals.
The Rural Obstetric Workforce in U.S. Hospitals: Challenges and Opportunities
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2015
Describes the healthcare and clinician types who are delivering babies in rural hospitals, such as family physicians, general surgeons, obstetricians, and midwives. Discusses the relationship between hospital birth volume and staffing models.
Nurse Staffing Levels and Quality of Care in Rural Nursing Homes
Policy Brief
University of Minnesota Rural Health Research Center
Date: 01/2015
This study's purpose was to examine the relationship between nurse staffing levels and care quality in rural nursing homes and to assess potential differences between hospital-based and freestanding rural nursing homes.

2014

The Use of Hospitalists by Small Rural Hospitals: Results of a National Survey
Journal Article
University of Minnesota Rural Health Research Center
Date: 06/2014
Examines reasons for using hospitalists, characteristics of hospitalist practices, and the impacts of hospitalist use in rural settings.
Rural-Urban Differences in Obstetric Care 2002-2010 and Implications for the Future
Journal Article
University of Minnesota Rural Health Research Center
Date: 01/2014
Measures obstetric care in both rural and urban hospitals to find if trends differ from rural and urban hospital locations.
Birth Volume and the Quality of Care in Rural Hospitals
Journal Article
University of Minnesota Rural Health Research Center
Date: 2014
Evaluates obstetric care quality in low-, medium-, and high-volume areas by using hospital discharge data.

2012

Quality Reporting for CAHs and Rural PPS Hospitals: The Potential Impact of Composite Measures
Policy Brief
Upper Midwest Rural Health Research Center
Date: 07/2012
As a part of a larger project that examined alternative ways of identifying high quality rural hospitals, this report assesses the use of composite scores for public reporting of quality measures as one way of addressing the low volume issue for small rural hospitals.