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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedMiller AC, Ward MM, Ullrich F
Emergency department telemedicine consults are associated with faster time-to-electrocardiogram and time-to-fibrinolysis for myocardial infarction patients.
The objective of this study was to evaluate the impact of telemedicine on the timeliness of emergency acute myocardial infarction (AMI) care for patients presenting to rural emergency departments (EDs) with chest pain. Findings showed that, in telemedicine networks, telemedicine consultation during the ED visit was associated with improved timeliness of electrocardiogram evaluation and increased use of fibrinolytic reperfusion therapy for rural AMI patients.
AHRQ-funded; HS025753.
Citation: Miller AC, Ward MM, Ullrich F .
Emergency department telemedicine consults are associated with faster time-to-electrocardiogram and time-to-fibrinolysis for myocardial infarction patients.
Telemed J E Health 2020 Dec;26(12):1440-48. doi: 10.1089/tmj.2019.0273..
Keywords: Telehealth, Health Information Technology (HIT), Emergency Department, Rural Health, Heart Disease and Health, Cardiovascular Conditions
Kolak MA, Chen YT, Joyce S
Rural risk environments, opioid-related overdose, and infectious diseases: a multidimensional, spatial perspective.
The authors adapted a risk environment framework to characterize rural southern Illinois and to describe the relations of risk environments, opioid-related overdose, HIV, Hepatitis C, and sexually transmitted infection rates between 2015 and 2017. They identified pervasive risk hotspots in more populated locales with higher rates of overdose and HCV incidence, whereas emerging risk areas were isolated to more rural locales that had experienced an increase in analgesic opiate overdoses and generally lacked harm-reduction resources. They also found that at-risk areas were characterized with underlying socioeconomic vulnerability but in differing ways, reflecting a nuanced and shifting structural risk landscape.
AHRQ-funded; HS022433.
Citation: Kolak MA, Chen YT, Joyce S .
Rural risk environments, opioid-related overdose, and infectious diseases: a multidimensional, spatial perspective.
Int J Drug Policy 2020 Nov;85:102727. doi: 10.1016/j.drugpo.2020.102727..
Keywords: Rural Health, Opioids, Substance Abuse, Medication, Hepatitis, Risk, Behavioral Health
Green TC, Bratberg J, Baird J
Rurality and differences in pharmacy characteristics and community factors associated with provision of naloxone in the pharmacy.
Researchers studied pharmacy-level naloxone dispensed from one large US community pharmacy chain from the 1st quarter of 2013 to the 2nd quarter of 2017, examining associations between naloxone provision and pharmacy-level characteristics and community factors in two US states, Rhode Island and Massachusetts. They found that more rural pharmacies, pharmacies with higher volumes of all prescriptions and of buprenorphine, that sell more nonprescription syringes, that have drive-throughs and longer weekend hours, and that are located in communities with younger age distributions were associated with increased likelihood of ever dispensing naloxone and a greater number of naloxone doses dispensed. They concluded that pharmacy naloxone dispensing may be an especially effective strategy to alter the overdose risk environment in rural communities.
AHRQ-funded; HS024021.
Citation: Green TC, Bratberg J, Baird J .
Rurality and differences in pharmacy characteristics and community factors associated with provision of naloxone in the pharmacy.
Int J Drug Policy 2020 Nov;85:102602. doi: 10.1016/j.drugpo.2019.11.010..
Keywords: Medication, Provider: Pharmacist, Community-Based Practice, Rural Health
Zittleman L, Curcija K, Sutter C
Building capacity for medication assisted treatment in rural primary care Practices: the IT MATTTRs practice team training.
In response to rural communities and practice concerns related to opioid use disorder (OUD), the Implementing Technology and Medication Assisted Treatment Team Training in Rural Colorado study (IT MATTTRs) developed a training intervention for full primary care practice (PCP) teams in MAT for OUD. This evaluation reports on training implementation, participant satisfaction, and impact on perceived ability to deliver MAT.
AHRQ-funded; HS025065.
Citation: Zittleman L, Curcija K, Sutter C .
Building capacity for medication assisted treatment in rural primary care Practices: the IT MATTTRs practice team training.
J Prim Care Community Health 2020 Jan-Dec;11:2150132720953723. doi: 10.1177/2150132720953723..
Keywords: Medication, Primary Care, Opioids, Substance Abuse, Rural Health, Training, Education: Continuing Medical Education
Nagykaldi Z, Scheid D, Zhao YD
A sustainable model for preventive services in rural counties: the healthier together study.
The Healthier Together study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices located in 3 rural counties in Oklahoma. Forty-four eligible clinician practices participated in the study. Results showed that, although health care is under-resourced and segmented in many rural counties, when stakeholder partnerships are established, they may be able to achieve and economically sustain community-wide health improvement by creating a win-win situation for all partners.
AHRQ-funded; HS023237.
Citation: Nagykaldi Z, Scheid D, Zhao YD .
A sustainable model for preventive services in rural counties: the healthier together study.
J Am Board Fam Med 2020 Sep-Oct;33(5):698-706. doi: 10.3122/jabfm.2020.05.190357..
Keywords: Rural Health, Prevention, Primary Care: Models of Care, Primary Care, Community-Based Practice
Herb JN, Dunham LN, Mody G
Lung cancer surgical regionalization disproportionately worsens travel distance for rural patients.
Researchers hypothesized that lung cancer patients have been traveling further for surgery over time as regionalization has occurred, and this increased travel has primarily impacted rural patients. Using data from a North Carolina all-payer state discharge database, they found that the number of hospitals performing lung cancer resections decreased from 49 to 31 over the study period, and the proportion of patients receiving care at high-volume centers increased. Rural patient travel distance increased over time by 8.5 miles, with no change in urban patient travel distance. They concluded that, in North Carolina, lung cancer surgical regionalization occurred over the study period and was accompanied by increases in travel distance for rural patients only. They recommended further work to determine the effects of greater travel distance on patterns of cancer care for rural patients.
AHRQ-funded; HS000032.
Citation: Herb JN, Dunham LN, Mody G .
Lung cancer surgical regionalization disproportionately worsens travel distance for rural patients.
J Rural Health 2020 Sep;36(4):496-505. doi: 10.1111/jrh.12440..
Keywords: Cancer: Lung Cancer, Cancer, Rural Health, Surgery, Access to Care
Sutherland BL, Pecanac K, Bartels CM
Expect delays: poor connections between rural and urban health systems challenge
Rural Americans with diabetic foot ulcers (DFUs) face a 50% increased risk of major amputation compared to their urban counterparts. In this study, the investigators sought to identify health system barriers contributing to this disparity. The investigators concluded that poor connections across rural and urban healthcare systems were described as the primary health system barrier driving the rural disparity in major amputations.
AHRQ-funded; HS026279.
Citation: Sutherland BL, Pecanac K, Bartels CM .
Expect delays: poor connections between rural and urban health systems challenge
J Foot Ankle Res 2020 Jun 16;13(1):32. doi: 10.1186/s13047-020-00395-y..
Keywords: Rural Health, Health Systems, Disparities, Diabetes, Chronic Conditions, Healthcare Delivery
Longacre CF, Neprash HT, Shippee ND
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
This study characterizes the actual distance older breast cancer patients traveled to radiation treatment and the minimum distance necessary to reach radiation care, and examines whether any patient demographic or clinical factors are associated with greater travel distance. Findings showed that patients living in rural areas traveled on average nearly 3 times as far as those from urban areas, and their nearest facility was more than 4 times farther away. Older age, being single or widowed, and lower household income were significantly associated with shorter actual travel distance, while increasing rurality was significantly associated with greater actual and minimum travel distance to radiation treatment.
AHRQ-funded; HS026660.
Citation: Longacre CF, Neprash HT, Shippee ND .
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
J Rural Health 2020 Jun;36(3):334-46. doi: 10.1111/jrh.12413..
Keywords: Rural Health, Cancer: Breast Cancer, Cancer, Elderly, Women, Access to Care, Disparities
Mroz TM, Patterson DG, Frogner BK
The impact of Medicare's rural add-on payments on supply of home health agencies serving rural counties.
This analysis looked at the impact of Medicare’s rural add-on payments on supply of home health agencies serving rural counties. The authors used data from Home Health Compare. The results suggest that while supply changes are similar in rural counties adjacent to urban areas and urban counties regardless of add-on payments, only higher add-payments of 5 to 10 percent to rural counties keep them on pace with those in urban counties.
AHRQ-funded; HS024777.
Citation: Mroz TM, Patterson DG, Frogner BK .
The impact of Medicare's rural add-on payments on supply of home health agencies serving rural counties.
Health Aff 2020 Jun;39(6):949-57. doi: 10.1377/hlthaff.2019.00952..
Keywords: Elderly, Medicare, Home Healthcare, Rural Health, Payment, Access to Care
Mohr NM, Wu C, Ward MJ
Potentially avoidable inter-facilit transfer from Veterans Health Administration emergency departments: a cohort study.
The objective of this study was to describe ED-based inter-facility transfer practices within the Veterans Health Administration (VHA) and to estimate the proportion of potentially avoidable transfers. Results showed that VHA inter-facility transfer was commonly performed for mental health and cardiac evaluation, particularly for patients in rural settings. The proportion that are potentially avoidable is small. Future work should focus on improving capabilities to provide specialty evaluation locally for these conditions, possibly using telehealth solutions.
AHRQ-funded; HS025753.
Citation: Mohr NM, Wu C, Ward MJ .
Potentially avoidable inter-facilit transfer from Veterans Health Administration emergency departments: a cohort study.
BMC Health Serv Res 2020 Feb 12;20(1):110. doi: 10.1186/s12913-020-4956-6..
Keywords: Emergency Department, Hospitals, Healthcare Delivery, Access to Care, Rural Health
Parchman ML, Ike B, Osterhage KP
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
This paper discusses the barriers and facilitators to implementing changes in opioid prescription in rural areas using the Six Building Blocks evidence-based program to reduce opioid prescription in primary care practices. The program was implemented at 6 rural and rural-serving organizations with 20 clinic locations over a 15-month period. Interviews and focus groups with conducted with the organizations at the end of the program period. Facilitators included a desire to help patients and their community; external pressures to make changes in opioid management; a desire to reduce workplace stress; external support for the clinic; supportive clinic leadership; and receptivity of patients. Barriers included competing demands on clinicians and staff; a culture of clinician autonomy; inadequate data systems; and a lack of patient resources in rural areas.
AHRQ-funded; HS023750.
Citation: Parchman ML, Ike B, Osterhage KP .
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
J Clin Transl Sci 2020 Jan 10;4(5):425-30. doi: 10.1017/cts.2019.448..
Keywords: Opioids, Medication, Rural Health, Primary Care, Primary Care: Models of Care, Implementation, Pain, Chronic Conditions, Healthcare Delivery
Williams D, Reiter KL, Pink GH
Rural hospital mergers increased between 2005 and 2016-what did those hospitals look like?
The objective of this study was to determine whether key hospital-level financial and market characteristics were associated with whether rural hospitals merge. The investigators found that the types of rural hospitals that merged during the sample period differed from nonmerged rural hospitals. Rural hospitals with higher odds of merging were less profitable, for-profit, larger, and were less likely to be able to cover current debt.
AHRQ-funded; HS000032.
Citation: Williams D, Reiter KL, Pink GH .
Rural hospital mergers increased between 2005 and 2016-what did those hospitals look like?
Inquiry 2020 Jan-Dec;57:46958020935666. doi: 10.1177/0046958020935666..
Keywords: Rural Health, Hospitals
Kirby JB, Yabroff KR
AHRQ Author: Kirby JB
Rural-urban differences in access to primary care: beyond the usual source of care provider.
This study used 2014-2016 MEPS data to analyze differences between rural and urban areas to primary care access beyond the usual source of care provider. While rural residents were more likely to have a usual source of care, they were less likely to have a provider with office hours on nights and weekends.
AHRQ-authored.
Citation: Kirby JB, Yabroff KR .
Rural-urban differences in access to primary care: beyond the usual source of care provider.
Am J Prev Med 2020 Jan;58(1):89-96. doi: 10.1016/j.amepre.2019.08.026..
Keywords: Medical Expenditure Panel Survey (MEPS), Access to Care, Primary Care, Rural Health, Urban Health, Health Services Research (HSR)