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Articles 1 - 30 of 234
Full-Text Articles in Health Services Research
Diabetes Prevalence And Monitoring In Nonmetropolitan And Metropolitan Areas Within A Commercially Insured U.S. Population, Lindsey R. Hammerslag, Jeffery Talbert
Diabetes Prevalence And Monitoring In Nonmetropolitan And Metropolitan Areas Within A Commercially Insured U.S. Population, Lindsey R. Hammerslag, Jeffery Talbert
Rural & Underserved Health Research Center Publications
Overview of Key Findings
- Enrollees living in nonmetropolitan areas had 22% higher likelihood of having diabetes, even after controlling for factors like age and region.
- The prevalence of diabetes in 2019-2020 was 7.9% in nonmetropolitan areas and 6.2% in metropolitan areas.
- Annual hemoglobin A1c (HbA1c) testing occurred for 85.1% of nonmetropolitan and 85.7% of metropolitan enrollees with diabetes. After controlling for other factors, we found significantly lower testing for those in nonmetropolitan areas.
- For diabetic enrollees, having an HbA1c test in 2019 was associated with an 8% decrease in the likelihood of non-cardiovascular complications related to diabetes and a 6% …
Increased Rates Of Death From Unintentional Injury Among Non-Hispanic White, American Indian/Alaska Native, And Non-Metropolitan Communities, Lindsey R. Hammerslag, Jeffery Talbert, Tyrone F. Borders
Increased Rates Of Death From Unintentional Injury Among Non-Hispanic White, American Indian/Alaska Native, And Non-Metropolitan Communities, Lindsey R. Hammerslag, Jeffery Talbert, Tyrone F. Borders
Rural & Underserved Health Research Center Publications
Overview of Key Findings
- Living in a nonmetropolitan area is associated with an increase in the age-adjusted death rate from unintentional injuries, from 46.2 in metropolitan areas to 59.2 in nonmetropolitan areas in 2018, with all races/ethnicity groups affected except for non-Hispanic Black.
- The ratio of unintentional injury deaths in nonmetropolitan areas, compared to metropolitan areas, was 1.28 overall, ranging from 1.05 to 1.56 depending on race and ethnicity.
- American Indians and Alaska Natives have the highest rate of living in nonmetropolitan areas (39.5%), and this group has the greatest increase in death from unintentional injury associated with living in …
The Racial And Ethnic Diversity Of The Family Physician Workforce In Non-Metropolitan And Metropolitan Counties, Lars E. Peterson, Zachary J. Morgan
The Racial And Ethnic Diversity Of The Family Physician Workforce In Non-Metropolitan And Metropolitan Counties, Lars E. Peterson, Zachary J. Morgan
Rural & Underserved Health Research Center Publications
Overview of Key Findings
- The family physician workforce is becoming more racially diverse; however, non-metropolitan family physicians are not.
- Using data from over 24,000 family physicians who either registered to continue their American Board of Family Medicine (ABFM) certification or completed the graduate survey from 2017 to 2019, we found that early career family physicians are more diverse than later career physicians (66.9% vs. 72.8% White; 58.3% vs. 44.0% female) but, in both groups, the percentage of White non-metropolitan family physicians was even higher (82.7% to 90.5%).
- Minority non-metropolitan family physicians, particularly Black and Native American/Alaska Native physicians, are more …
Non-Metropolitan And Metropolitan Trends In Mental Health Treatment Availability In Community Health And Community Mental Health Centers, Tyrone F. Borders, Timothy Williams, Katherine Youngen, Julia Cecil
Non-Metropolitan And Metropolitan Trends In Mental Health Treatment Availability In Community Health And Community Mental Health Centers, Tyrone F. Borders, Timothy Williams, Katherine Youngen, Julia Cecil
Rural & Underserved Health Research Center Publications
Key Findings
The supply of community mental health centers (CMHCs) decreased substantially from 2000 to 2019 and became nearly non-existent in non-metropolitan counties.
- The number of CMHCs in non-metropolitan counties declined from 182 to 15.
- The number of CMHCs in metropolitan counties declined from 582 to 104.
The supply of community health centers (CHCs) offering mental health services increased substantially over the same time period, or from 2000 to 2019.
- The number of CHCs in non-metropolitan counties increased from 184 to 573.
- The number of CHCs in metropolitan counties increased from 126 to 797.
Bedside Nurses' Perceptions Of Effective Nurse-Physician Communication In General Medical Units: A Qualitative Study, Hirotaka Kato, Jessica M. Clouser, Preetham Talari, Nikita Vundi, Akosua Adu, Kishore Karri, Kathy B Isaacs, Mark V Williams, Romil Chadha, Jing Li
Bedside Nurses' Perceptions Of Effective Nurse-Physician Communication In General Medical Units: A Qualitative Study, Hirotaka Kato, Jessica M. Clouser, Preetham Talari, Nikita Vundi, Akosua Adu, Kishore Karri, Kathy B Isaacs, Mark V Williams, Romil Chadha, Jing Li
Center for Health Services Research Faculty Publications
Background
There is a dearth of research on successful interventions to improve nurse-physician communication (NPC). An important step is identifying what matters to bedside nurses and their perceptions of effective NPC communications and actions.
Methods
We conducted three focus groups with a total of 19 medical unit nurses across two hospitals in one academic medical center in the United States. Using a convenience sampling strategy, five to eight nurses voluntarily participated in each focus group. The recording was transcribed verbatim and two independent coders performed coding and resolved any discrepancies in codes. Qualitative content analysis was pursued to identify themes …
Serious Mental Illness And Mental Health Treatment Utilization Among Adults Residing In Non-Metropolitan And Metropolitan Counties, Tyrone F. Borders, Timothy Williams
Serious Mental Illness And Mental Health Treatment Utilization Among Adults Residing In Non-Metropolitan And Metropolitan Counties, Tyrone F. Borders, Timothy Williams
Rural & Underserved Health Research Center Publications
Key Findings
The past year prevalence of serious mental illness (SMI) was significantly higher among non-metropolitan than metropolitan (5.90% vs. 5.18%, P < .03) adults.
Only 67.58% of non-metropolitan and 64.29% of metropolitan adults with SMI received any mental health (MH) treatment in the past year.
Additional analyses revealed the following non-metropolitan/metropolitan treatment differences:
- A higher percentage of non-metropolitan than metropolitan adults with SMI received only medication for MH treatment (24.50% vs. 18.53%, P < .02).
- A higher percentage of metropolitan than non-metropolitan adults with SMI received inpatient, outpatient, and medication (5.42% vs. 2.63%, P < .02).
- A significantly higher percentage of non-metropolitan than metropolitan adults with …
Reported Barriers To Hepatitis C Treatment Among Pregnant And Early-Parenting Mothers Undergoing Substance Use Disorder Treatment In One U.S. State, Ayooluwatomiwa Deborah Adekunle, Kathi L. Harp, Zaynab G. Al-Abdali, Agatha S. Critchfield, Sheila Barnhart, Kathleen T. Winter
Reported Barriers To Hepatitis C Treatment Among Pregnant And Early-Parenting Mothers Undergoing Substance Use Disorder Treatment In One U.S. State, Ayooluwatomiwa Deborah Adekunle, Kathi L. Harp, Zaynab G. Al-Abdali, Agatha S. Critchfield, Sheila Barnhart, Kathleen T. Winter
Health Management and Policy Faculty Publications
Nationwide, the prevalence of the hepatitis C virus (HCV) has risen in recent years. At least 90% of infected persons must be treated to achieve global elimination targets. The current study aimed to explore barriers to, and facilitators of, direct-acting antiviral (DAA) HCV treatment uptake amongst pregnant and early-parenting women undergoing comprehensive substance use treatment. Twenty participants with documented HCV antibody positivity were recruited from two substance use treatment centers in central Kentucky. Semi-structured interviews were conducted to explore knowledge about HCV, previous experiences, and intentions to seek care. Themes were extracted using an inductive analytical approach. Most participants were …
Persistent Polypharmacy And Fall Injury Risk: The Health, Aging And Body Composition Study, Lingshu Xue, Robert M. Boudreau, Julie M. Donohue, Janice C. Zgibor, Zachary A. Marcum, Tina Costacou, Anne B. Newman, Teresa M. Waters, Elsa S. Strotmeyer
Persistent Polypharmacy And Fall Injury Risk: The Health, Aging And Body Composition Study, Lingshu Xue, Robert M. Boudreau, Julie M. Donohue, Janice C. Zgibor, Zachary A. Marcum, Tina Costacou, Anne B. Newman, Teresa M. Waters, Elsa S. Strotmeyer
Health Management and Policy Faculty Publications
Background
Older adults receive treatment for fall injuries in both inpatient and outpatient settings. The effect of persistent polypharmacy (i.e. using multiple medications over a long period) on fall injuries is understudied, particularly for outpatient injuries. We examined the association between persistent polypharmacy and treated fall injury risk from inpatient and outpatient settings in community-dwelling older adults.
Methods
The Health, Aging and Body Composition Study included 1764 community-dwelling adults (age 73.6 ± 2.9 years; 52% women; 38% black) with Medicare Fee-For-Service (FFS) claims at or within 6 months after 1998/99 clinic visit. Incident fall injuries (N = 545 in …
Association Between Post-Hospital Clinic And Telephone Follow-Up Provider Visits With 30-Day Readmission Risk In An Integrated Health System, Huong Q. Nguyen, Aileen Baecker, Timothy Ho, Dan N. Huynh, Heather L. Watson, Jing Li, Ernest Shen
Association Between Post-Hospital Clinic And Telephone Follow-Up Provider Visits With 30-Day Readmission Risk In An Integrated Health System, Huong Q. Nguyen, Aileen Baecker, Timothy Ho, Dan N. Huynh, Heather L. Watson, Jing Li, Ernest Shen
Center for Health Services Research Faculty Publications
BACKGROUND: Follow-up visits with clinic providers after hospital discharge may not be feasible for some patients due to functional limitations, transportation challenges, need for physical distancing, or fear of exposure especially during the current COVID-19 pandemic.
METHODS: The aim of the study was to determine the effects of post-hospital clinic (POSH) and telephone (TPOSH) follow-up provider visits versus no visit on 30-day readmission. We used a retrospective cohort design based on data from 1/1/2017 to 12/31/2019 on adult patients (n = 213,513) discharged home from 15 Kaiser Permanente Southern California hospitals. Completion of POSH or TPOSH provider visits within …
Development And Psychometric Properties Of Surveys To Assess Patient And Family Caregiver Experience With Care Transitions, Joann Sorra, Katarzyna Zebrak, Deborah Carpenter, Theresa Famolaro, John Rauch, Jing Li, Terry Davis, Huong Q. Nguyen, Megan Mcintosh, Suzanne Mitchell, Karen B. Hirschman, Carol Levine, Jessica Miller Clouser, Jane Brock, Mark V. Williams
Development And Psychometric Properties Of Surveys To Assess Patient And Family Caregiver Experience With Care Transitions, Joann Sorra, Katarzyna Zebrak, Deborah Carpenter, Theresa Famolaro, John Rauch, Jing Li, Terry Davis, Huong Q. Nguyen, Megan Mcintosh, Suzanne Mitchell, Karen B. Hirschman, Carol Levine, Jessica Miller Clouser, Jane Brock, Mark V. Williams
Center for Health Services Research Faculty Publications
Background
The purpose of this study was to develop and administer surveys that assess patient and family caregiver experiences with care transitions and examine the psychometric properties of the surveys. The surveys were designed to ask about 1) the transitional care services that matter most to patients and their caregivers and 2) care outcomes, including the overall quality of transitional care they received, patient self-reported health, and caregiver effort/stress.
Methods
Survey items were developed based on a review of the literature, existing surveys, focus groups, site visits, stakeholder and expert input, and patient and caregiver cognitive interviews. We administered mail …
Content Analysis Of Digital Media Coverage Of The Human Papillomavirus Vaccine School-Entry Requirement Policy In Puerto Rico, Vivian Colón-López, Vilnery Rivera-Figueroa, Glizette O. Arroyo-Morales, Diana T. Medina-Laabes, Roxana Soto-Abreu, Manuel Rivera-Encarnación, Olga L. Díaz-Miranda, Ana P. Ortiz, Katelyn B. Wells, Coralia Vázquez-Otero, Pamela C. Hull
Content Analysis Of Digital Media Coverage Of The Human Papillomavirus Vaccine School-Entry Requirement Policy In Puerto Rico, Vivian Colón-López, Vilnery Rivera-Figueroa, Glizette O. Arroyo-Morales, Diana T. Medina-Laabes, Roxana Soto-Abreu, Manuel Rivera-Encarnación, Olga L. Díaz-Miranda, Ana P. Ortiz, Katelyn B. Wells, Coralia Vázquez-Otero, Pamela C. Hull
Behavioral Science Faculty Publications
BACKGROUND: In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11-12 years old. Evidence suggests that the content of media coverage may impact people's perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR.
METHODS: A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix …
Factors That Influence Enrollment In Syringe Services Programs In Rural Areas: A Qualitative Study Among Program Clients In Appalachian Kentucky, Umedjon Ibragimov, Katherine E. Cooper, Evan Batty, April M. Ballard, Monica Fadanelli, Skylar B. Gross, Emma M. Klein, Scott Lockard, April M. Young, Hannah L. F. Cooper
Factors That Influence Enrollment In Syringe Services Programs In Rural Areas: A Qualitative Study Among Program Clients In Appalachian Kentucky, Umedjon Ibragimov, Katherine E. Cooper, Evan Batty, April M. Ballard, Monica Fadanelli, Skylar B. Gross, Emma M. Klein, Scott Lockard, April M. Young, Hannah L. F. Cooper
Epidemiology and Environmental Health Faculty Publications
BACKGROUND: Enrolling sufficient number of people who inject drugs (PWID) into syringe services programs (SSP) is important to curtail outbreaks of drug-related harms. Still, little is known about barriers and facilitators to SSP enrollment in rural areas with no history of such programs. This study's purpose was to develop a grounded theory of the role of the risk environment and individual characteristics of PWID in shaping SSP enrollment in rural Kentucky.
METHODS: We conducted one-on-one semi-structured interviews with 41 clients of 5 SSPs that were established in rural counties in Appalachian Kentucky in 2017-2018. Interviews covered PWID needs, the process …
Planning Implementation Success Of Syncope Clinical Practice Guidelines In The Emergency Department Using Cfir Framework, Jing Li, Susan S. Smyth, Jessica M. Clouser, Colleen A. Mcmullen, Vedant A. Gupta, Mark V. Williams
Planning Implementation Success Of Syncope Clinical Practice Guidelines In The Emergency Department Using Cfir Framework, Jing Li, Susan S. Smyth, Jessica M. Clouser, Colleen A. Mcmullen, Vedant A. Gupta, Mark V. Williams
Center for Health Services Research Faculty Publications
Background and Objectives: Overuse and inappropriate use of testing and hospital admission are common in syncope evaluation and management. Though guidelines are available to optimize syncope care, research indicates that current clinical guidelines have not significantly impacted resource utilization surrounding emergency department (ED) evaluation of syncope. Matching implementation strategies to barriers and facilitators and tailoring strategies to local context hold significant promise for a successful implementation of clinical practice guidelines (CPG). Our team applied implementation science principles to develop a stakeholder-based implementation strategy. Methods and Materials: We partnered with patients, family caregivers, frontline clinicians and staff, and health system administrators …
Development And Psychometric Properties Of Surveys To Assess Provider Perspectives On The Barriers And Facilitators Of Effective Care Transitions, Maurice C. Johnson Jr., Helen Liu, Joann Sorra, Jane Brock, Brianna Gass, Jing Li, Jessica Miller Clouser, Karen Hirschman, Deborah Carpenter, Huong Q. Nguyen, Mark V. Williams
Development And Psychometric Properties Of Surveys To Assess Provider Perspectives On The Barriers And Facilitators Of Effective Care Transitions, Maurice C. Johnson Jr., Helen Liu, Joann Sorra, Jane Brock, Brianna Gass, Jing Li, Jessica Miller Clouser, Karen Hirschman, Deborah Carpenter, Huong Q. Nguyen, Mark V. Williams
Center for Health Services Research Faculty Publications
Background
The quality of the discharge process and effective care transitions between settings of care are critical to minimize gaps in patient care and reduce hospital readmissions. Few studies have explored which care transition components and strategies are most valuable to patients and providers. This study describes the development, pilot testing, and psychometric analysis of surveys designed to gain providers’ perspectives on current practices in delivering transitional care services.
Methods
We underwent a comprehensive process to develop items measuring unique aspects of care transitions from the perspectives of the three types of providers (downstream, ambulatory, and hospital providers). The process …
Measuring The Impact Of The Affordable Care Act Medicaid Expansion On Access To Primary Care Using An Interrupted Time Series Approach, Elizabeth A. Brown, Brandi M. White, Walter J. Jones, Mulugeta Gebregziabher, Kit N. Simpson
Measuring The Impact Of The Affordable Care Act Medicaid Expansion On Access To Primary Care Using An Interrupted Time Series Approach, Elizabeth A. Brown, Brandi M. White, Walter J. Jones, Mulugeta Gebregziabher, Kit N. Simpson
Health and Clinical Sciences Faculty Publications
BACKGROUND: The Patient Protection and Affordable Care Act of 2010, commonly referred to as the Affordable Care Act (ACA), was created to increase access to primary care, improve quality of care, and decrease healthcare costs. A key provision in the law that mandated expansion of state Medicaid programme changed when states were given the option to voluntarily expand Medicaid. Our study sought to measure the impact of ACA Medicaid expansion on preventable hospitalization (PH) rates, a measure of access to primary care.
METHODS: We performed an interrupted time series analysis of quarterly hospitalization rates across eight states from 2012 to …
Medicare-Paid Naloxone: Trends In Non-Metropolitan And Metropolitan Areas, Chris Delcher, Yue Cheng, Minji Sohn, Jeffery C. Talbert, Patricia R. Freeman
Medicare-Paid Naloxone: Trends In Non-Metropolitan And Metropolitan Areas, Chris Delcher, Yue Cheng, Minji Sohn, Jeffery C. Talbert, Patricia R. Freeman
Rural & Underserved Health Research Center Publications
Overview of Key Findings
- Medicare pays for the largest share (> 30%) of naloxone dispensed from retail pharmacies in non-metropolitan areas.
- Medicare-paid dispensing has grown since 2013, but from 2017-2018 dispensing growth in non-metropolitan areas slowed considerably compared to metropolitan areas (42% v 121%, respectively).
- As of 2018, the rate of naloxone dispensing to Medicare enrollees in metropolitan areas was approximately double that in non-metropolitan areas (4.9 v 2.9 per 1,000 enrollees, respectively).
Evaluation Of Glutaminase Expression In Prostate Adenocarcinoma And Correlation With Clinicopathologic Parameters, Zin W. Myint, Ramon C. Sun, Patrick J. Hensley, Andrew C. James, Peng Wang, Stephen E. Strup, Robert J. Mcdonald, Donglin Yan, William H. St. Clair, Derek B. Allison
Evaluation Of Glutaminase Expression In Prostate Adenocarcinoma And Correlation With Clinicopathologic Parameters, Zin W. Myint, Ramon C. Sun, Patrick J. Hensley, Andrew C. James, Peng Wang, Stephen E. Strup, Robert J. Mcdonald, Donglin Yan, William H. St. Clair, Derek B. Allison
Internal Medicine Faculty Publications
High Glutaminase (GLS1) expression may have prognostic implications in colorectal and breast cancers; however, high quality data for expression in prostate cancer (PCa) are lacking. The purpose of this study is to investigate the status of GLS1 expression in PCa and correlated expression levels with clinicopathologic parameters. This study was conducted in two phases: an exploratory cohort analyzing RNA-Seq data for GLS1 from The Cancer Genome Atlas (TCGA) data portal (246 PCa samples) and a GLS1 immunohistochemical protein expression cohort utilizing a tissue microarray (TMA) (154 PCa samples; 41 benign samples) for correlation with clinicopathologic parameters. In the TCGA cohort, …
Spatial Analysis Of Health Care Utilization Among Medicare Beneficiaries With Coal Workers’ Pneumoconiosis And Other Related Pneumoconiosis, Ahmed A. Arif, Claudio Owusu, Rajib Paul, Christopher M. Blanchette, Ripsi P. Patel, Tyrone F. Borders
Spatial Analysis Of Health Care Utilization Among Medicare Beneficiaries With Coal Workers’ Pneumoconiosis And Other Related Pneumoconiosis, Ahmed A. Arif, Claudio Owusu, Rajib Paul, Christopher M. Blanchette, Ripsi P. Patel, Tyrone F. Borders
Rural & Underserved Health Research Center Publications
Overview of Key Findings
- The states with the highest number of Medicare beneficiaries with coal workers’ pneumoconiosis (CWP) were Kentucky, West Virginia, Virginia, and Pennsylvania.
- Significant clustering of health care utilization rates for Medicare beneficiaries with CWP was observed in the central Appalachian states of Kentucky, West Virginia, and Virginia.
- Significant clustering of health care utilization rates for Medicare beneficiaries with Other Related Pneumoconiosis was observed in Appalachia and the southeast parts of Texas and Louisiana. This clustering merits additional research to understand underlying disease etiology.
Did Medicaid Slow Declines In Access To Health Care During The Great Recession?, Joseph A. Benitez, Victoria E. Perez, Jie Chen
Did Medicaid Slow Declines In Access To Health Care During The Great Recession?, Joseph A. Benitez, Victoria E. Perez, Jie Chen
Health Management and Policy Faculty Publications
OBJECTIVE: We examine whether broadened access to Medicaid helped insulate households from declines in health coverage and health care access linked to the 2007-2009 Great Recession.
DATA SOURCE: 2004-2010 Behavioral Risk Factor Surveillance System (BRFSS).
STUDY DESIGN: Flexible difference-in-difference regressions were used to compare the impact of county-level unemployment on health care access in states with generous Medicaid eligibility guidelines versus states with restrictive guidelines.
DATA COLLECTION/EXTRACTION METHODS: Nonelderly adults (aged 19-64) in the BRFSS were linked to county unemployment rates from the Bureau of Labor Statistics' Local Area Unemployment Statistics Program. We created a Medicaid generosity index by simulating …
Measurement Matters: Changing Penalty Calculations Under The Hospital Acquired Condition Reduction Program (Hacrp) Cost Hospitals Millions, Olga A. Vsevolozhskaya, Karina C. Manz, Pierre M. Zephyr, Teresa M. Waters
Measurement Matters: Changing Penalty Calculations Under The Hospital Acquired Condition Reduction Program (Hacrp) Cost Hospitals Millions, Olga A. Vsevolozhskaya, Karina C. Manz, Pierre M. Zephyr, Teresa M. Waters
Biostatistics Faculty Publications
BACKGROUND: Since October 2014, the Centers for Medicare and Medicaid Services has penalized 25% of U.S. hospitals with the highest rates of hospital-acquired conditions under the Hospital Acquired Conditions Reduction Program (HACRP). While early evaluations of the HACRP program reported cumulative reductions in hospital-acquired conditions, more recent studies have not found a clear association between receipt of the HACRP penalty and hospital quality of care. We posit that some of this disconnect may be driven by frequent scoring updates. The sensitivity of the HACRP penalties to updates in the program's scoring methodology has not been independently evaluated.
METHODS: We used …
Improving Evidence-Based Grouping Of Transitional Care Strategies In Hospital Implementation Using Statistical Tools And Expert Review, Jing Li, Gaixin Du, Jessica Miller Clouser, Arnold J. Stromberg, Glen Mays, Joann Sorra, Jane Brock, Terry Davis, Suzanne Mitchell, Huong Q. Nguyen, Mark V. Williams
Improving Evidence-Based Grouping Of Transitional Care Strategies In Hospital Implementation Using Statistical Tools And Expert Review, Jing Li, Gaixin Du, Jessica Miller Clouser, Arnold J. Stromberg, Glen Mays, Joann Sorra, Jane Brock, Terry Davis, Suzanne Mitchell, Huong Q. Nguyen, Mark V. Williams
Center for Health Services Research Faculty Publications
BACKGROUND: As health systems transition to value-based care, improving transitional care (TC) remains a priority. Hospitals implementing evidence-based TC models often adapt them to local contexts. However, limited research has evaluated which groups of TC strategies, or transitional care activities, commonly implemented by hospitals correspond with improved patient outcomes. In order to identify TC strategy groups for evaluation, we applied a data-driven approach informed by literature review and expert opinion.
METHODS: Based on a review of evidence-based TC models and the literature, focus groups with patients and family caregivers identifying what matters most to them during care transitions, and expert …
Risky Substance Use Behaviors Among Adults Residing In Non-Metropolitan And Metropolitan Counties In The United States, 2017-2018, Tyrone F. Borders, Michael D. Singleton, Katherine Youngen
Risky Substance Use Behaviors Among Adults Residing In Non-Metropolitan And Metropolitan Counties In The United States, 2017-2018, Tyrone F. Borders, Michael D. Singleton, Katherine Youngen
Rural & Underserved Health Research Center Publications
Overview of Key Findings
Tobacco Use. Non-metropolitan adults had significantly higher prevalence rates of past year tobacco use (34.7% vs. 27.9%), daily cigarette use in the past 30 days (16.5% vs. 10.3%), and smoking at least 1 pack of cigarettes per day in the past 30 days (46.9% vs. 39.1%) than metropolitan adults.
Alcohol Use. Non-metropolitan adults had a lower prevalence rate of past year alcohol use (64.0% vs. 71.0%), past 30-day alcohol use (48.7% vs. 56.6%), and past 30-day binge drinking (24.5% vs. 26.7%) than metropolitan adults.
Illicit Drug Use. Overall illicit drug use was significantly …
Risky Substance Use Behaviors Among Adolescents Residing In Non-Metropolitan And Metropolitan Counties In The United States, 2017-2018, Tyrone F. Borders, Michael D. Singleton, Katherine Youngen
Risky Substance Use Behaviors Among Adolescents Residing In Non-Metropolitan And Metropolitan Counties In The United States, 2017-2018, Tyrone F. Borders, Michael D. Singleton, Katherine Youngen
Rural & Underserved Health Research Center Publications
Overview of Key Findings
Tobacco Use. The prevalence of any past year tobacco use was significantly higher among non-metropolitan than metropolitan adolescents (13.9% vs. 8.3%). Daily cigarette use in the past 30 days was more than 3 times more prevalent among non-metropolitan than metropolitan adolescents (1.0% vs. 0.3%) and the difference was also statistically significant.
Alcohol Use. Alcohol was the most commonly used substance among both non-metropolitan and metropolitan adolescents, although the differences in prevalence rates for past year and past 30-day alcohol use were not statistically significant. In the past year, 21.8% of non-metropolitan and 21.7% of …
Ethics And Economics Of The Covid-19 Pandemic In The United States, Peter Hilsenrath, Tyrone F. Borders
Ethics And Economics Of The Covid-19 Pandemic In The United States, Peter Hilsenrath, Tyrone F. Borders
Health Management and Policy Faculty Publications
The Covid-19 experience provides a natural experiment in personal and social ethics. Difficult decisions are routinely made to optimize lives and livelihoods. This commentary provides background and insight into the ethical and economic foundations underpinning dilemmas of this historic pandemic.
Preterm Birth Prevention In Appalachian Kentucky: Understanding Barriers And Facilitators Related To Transvaginal Ultrasound Cervical Length Surveillance Among Prenatal Care Providers, Anna Hansen, Mairead E. Moloney, Cynthia Cockerham-Morris, Jing Li, Niraj R. Chavan
Preterm Birth Prevention In Appalachian Kentucky: Understanding Barriers And Facilitators Related To Transvaginal Ultrasound Cervical Length Surveillance Among Prenatal Care Providers, Anna Hansen, Mairead E. Moloney, Cynthia Cockerham-Morris, Jing Li, Niraj R. Chavan
Sociology Faculty Publications
Background: Appalachian Kentucky has higher-than-average rates of preterm birth (PTB)—a health disparity associated with increased maternal and fetal/neonatal morbidity and neonatal mortality. Transvaginal ultrasound (TVU) cervical length measurement is the best predictor of PTB risk, but is underutilized in Appalachia. This study explores prenatal care providers' TVU-related knowledge and practices, and identifies barriers and facilitators, which impact the adoption of this evidence-based technology.
Materials and Methods: This study recruited providers from three Appalachian Kentucky health care sites. Prenatal care providers took part in semistructured interviews and completed brief survey scales. Questions focused on PTB knowledge, TVU-related barriers, and suggestions for …
Rural/Urban Disparities In The Utilization Of Health And Behavioral Assessments/Interventions In The Fee-For-Service Medicare Population, Christian Rhudy, Eugene Shin, Jeffery C. Talbert
Rural/Urban Disparities In The Utilization Of Health And Behavioral Assessments/Interventions In The Fee-For-Service Medicare Population, Christian Rhudy, Eugene Shin, Jeffery C. Talbert
Rural & Underserved Health Research Center Publications
Overview of Key Findings
- In 2016, rural county residents represented 21.8% of the fee-for-service (FFS) Medicare population, but only 1.6% of rural FFS beneficiaries live in a county with local utilization of Health and Behavioral Assessments and Interventions (HBAI) services.
- Utilization of HBAI services in 2016 occurred in 19 (9.7%) rural counties and 176 (90.3%) urban counties.
- Average utilization rates of HBAI services were higher in rural counties than urban counties (0.7% vs. 0.4%).
Rural/Urban Disparities In Utilization Of Diabetes Self-Management Training To The Fee-For-Service Medicare Population, Christian Rhudy, Aric Schadler, Jeffery C. Talbert
Rural/Urban Disparities In Utilization Of Diabetes Self-Management Training To The Fee-For-Service Medicare Population, Christian Rhudy, Aric Schadler, Jeffery C. Talbert
Rural & Underserved Health Research Center Publications
Overview of Key Findings
- In 2016, rural fee-for-service (FFS) Medicare beneficiaries represented 21.7% of the population diagnosed with diabetes, but only 2.7% of the population utilizing Diabetes Self-Management Training.
- Utilization of DSMT services in 2016 occurred in 76 rural counties and 309 urban counties.
- Average utilization rates of DSMT services were greater in rural counties than urban counties (5.5% vs. 2.5%).
Major Depression, Treatment Receipt, And Treatment Sources Among Non-Metropolitan And Metropolitan Adults, Tyrone F. Borders
Major Depression, Treatment Receipt, And Treatment Sources Among Non-Metropolitan And Metropolitan Adults, Tyrone F. Borders
Rural & Underserved Health Research Center Publications
Overview of Key Findings
- 7.8% of non-metropolitan (weighted number of persons=2,755,020) and 7.1% of metropolitan (weighted number of persons=14,868,655) adults had past year major depression.
- Treatment receipt (seeing a health professional or using prescription medication for depressive feelings) was similar among non-metropolitan (68.0%) and metropolitan (64.6%) adults.
- A closer examination of the type and source of treatment revealed the following:
- Rates of seeing a health professional were similar among non-metropolitan (60.8%) and metropolitan (58.4%) adults, but rates of using prescription medication for depressive feelings were higher among non-metropolitan (58.2%) than metropolitan (48.6%) adults.
- Rates of visiting a general practice/family doctor …
Rural/Urban Disparities In Utilization Of Medical Nutrition Therapy To The Fee-For-Service Medicare Population, Christian Rhudy, Eugene Shin, Jeffery C. Talbert
Rural/Urban Disparities In Utilization Of Medical Nutrition Therapy To The Fee-For-Service Medicare Population, Christian Rhudy, Eugene Shin, Jeffery C. Talbert
Rural & Underserved Health Research Center Publications
Overview of Key Findings
- In 2016, 21.8% of the fee-for-service (FFS) Medicare population resided in a rural county, but only 3.7% of enrollees residing in a county with utilization of Medical Nutrition Therapy (MNT) services were rural county residents.
- Utilization of MNT services in 2016 occurred in 92 rural counties and 388 urban counties.
- Average utilization rates of MNT services were greater in rural counties than urban counties (3.1% vs. 1.9%).
Healthcare Reform In The U.S. Must Be Driven By Policy And Data, Not Politics And Idealogy, Teresa M. Waters, Michael Karpf
Healthcare Reform In The U.S. Must Be Driven By Policy And Data, Not Politics And Idealogy, Teresa M. Waters, Michael Karpf
Health Management and Policy Faculty Publications
Background U.S. healthcare spending will reach 20% of GDP by 2026. Despite this spending, almost 14% of our under-65 population still lacks health insurance and out-of-pocket healthcare spending is high. To date, much of the healthcare reform debate has focused on who pays—the government, employers or individuals. Objective To review current healthcare reform issues and evidence. Method We address the questions of how much we pay, how we pay and what we receive for the money as a potential foundation for constructive dialogue. Results U.S. healthcare spending continues to exceed that of other countries, without offering universal coverage. Notwithstanding coverage …