National Healthcare Quality and Disparities Report
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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 8 of 8 Research Studies DisplayedShear K, Rice H, Garabedian PM
Management of fall risk among older adults in diverse primary care settings.
The purpose of this study was to describe how urban and rural primary care staff and older adults manage fall risk and factors relevant to the application of computerized clinical decision support (CCDS). METHODS: Interviews, contextual inquiries, and workflow observations were analyzed. The study found that participants valued fall prevention and described similar approaches. Variations in available resources existed between rural and urban locations. Participants wanted evidence-based guidance incorporated into workflows to bridge gaps in skills.
AHRQ-funded; HS027557.
Citation: Shear K, Rice H, Garabedian PM .
Management of fall risk among older adults in diverse primary care settings.
J Appl Gerontol 2023 Nov; 42(11):2219-32. doi: 10.1177/07334648231185757..
Keywords: Falls, Elderly, Primary Care, Rural Health, Rural/Inner-City Residents
Sun N, Hua CL, Qiu X
Urban and rural differences in trajectories of depressive symptoms in later life in the United States.
This research had two primary goals: to examine the relationship between urban residence and trajectories of depressive symptoms and to investigate whether this relationship differs by social isolation and loneliness. The investigators conducted latent growth curve analysis to predict both baseline and trajectories of depression based on urban or rural residency. Findings of this study served to better understand how social and geographic contexts shaped long-term well-being of older adults.
AHRQ-funded; HS000011.
Citation: Sun N, Hua CL, Qiu X .
Urban and rural differences in trajectories of depressive symptoms in later life in the United States.
J Appl Gerontol 2022 Jan;41(1):148-57. doi: 10.1177/0733464820972527..
Keywords: Elderly, Rural Health, Depression, Behavioral Health
Anderson MC, Evans E, Zonfrillo MR
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
This study compared differences in outcomes for older adults with traumatic brain injury (TBI) in rural and urban settings by 1) comparing the rates of successful community discharge; and 2) reasons for not achieving successful discharge. This retrospective national cohort study looked at skilled nursing facility (SNF) patients aged 66 and older using Medicare inpatient claims with Minimum Data Set assessments. A total of 11,771 SNFs were identified with a total population of 61,021 Medicare beneficiaries discharged to a SNF following hospitalization for TBI between 2011 and 2015. Patients in rural settings had lower rates of successful discharge compared with patients in urban settings (52.1% vs 58.5%). Reasons for unsuccessful discharge differed between rural and urban settings with rural patients less likely to discharged from SNF within 100 days although they were less likely to be rehospitalized within 30 days of SNF discharge.
AHRQ-funded; HS000011.
Citation: Anderson MC, Evans E, Zonfrillo MR .
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
J Am Geriatr Soc 2021 Jun;69(6):1601-08. doi: 10.1111/jgs.17065..
Keywords: Elderly, Brain Injury, Trauma, Rural Health, Urban Health, Rehabilitation, Nursing Homes
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
Vyas A, Madhavan SS, Sambamoorthi U
Differences in Medicare expenditures between Appalachian and nationally representative cohorts of elderly women with breast cancer: an application of decomposition technique.
The objective of this study was to determine Medicare expenditures during the initial phase of care among women in West Virginia (WV) who were Medicare beneficiaries with BC and compare them with national estimates. It found that the difference in average Medicare expenditures between the elderly beneficiaries with BC from a rural state (WV) and their national counterparts narrowed but remained significantly lower after multivariate adjustment.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan SS, Sambamoorthi U .
Differences in Medicare expenditures between Appalachian and nationally representative cohorts of elderly women with breast cancer: an application of decomposition technique.
J Natl Compr Canc Netw 2017 May;15(5):578-87.
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Keywords: Cancer: Breast Cancer, Elderly, Healthcare Costs, Medicare, Rural Health
Batsis JA, Pletcher SN, Stahl JE
Telemedicine and primary care obesity management in rural areas - innovative approach for older adults?
The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity. This review outlines some of the challenges with the current benefit and proposed solutions in overcoming rural primary care barriers to implementation, including changes in staffing models.
AHRQ-funded; HS021681.
Citation: Batsis JA, Pletcher SN, Stahl JE .
Telemedicine and primary care obesity management in rural areas - innovative approach for older adults?
BMC Geriatr 2017 Jan 5;17(1):6. doi: 10.1186/s12877-016-0396-x.
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Keywords: Telehealth, Primary Care, Obesity, Rural Health, Elderly
Toth M, Holmes M, Van Houtven C
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
This study tested whether rural Medicare beneficiaries have a lower likelihood of follow-up care and greater likelihood of a readmission and ED visit within 30 days postdischarge, compared with urban beneficiaries. The results provide evidence of lower quality postdischarge care for Medicare beneficiaries in rural settings.
AHRQ-funded; HS000032.
Citation: Toth M, Holmes M, Van Houtven C .
Rural Medicare beneficiaries have fewer follow-up visits and greater emergency department use postdischarge.
Med Care 2015 Sep;53(9):800-8. doi: 10.1097/mlr.0000000000000401..
Keywords: Rural Health, Elderly, Medicare, Hospital Readmissions, Emergency Department, Hospital Discharge