Rural Health
Resources by Topic: Access
Characteristics and Trends of Critical Access Hospitals That Own or Operate Ambulance Services
Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Rural Access to Certified Community Behavioral Health Clinics (CCBHCs)
Examines access to, and services offered by, Certified Community Behavioral Health Clinics (CCBHCs) in rural and urban communities. Also compares services at CCBHCs with those offered at other mental health clinics. Features state-level maps showing CCBHC counts by state, and statistics on services counts in CCBHCs and other mental health facilities, with breakdowns by urban and rural areas.
Author(s): Aaron P. Smith, Jeffrey Talbert
Date: 05/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Examines access to, and services offered by, Certified Community Behavioral Health Clinics (CCBHCs) in rural and urban communities. Also compares services at CCBHCs with those offered at other mental health clinics. Features state-level maps showing CCBHC counts by state, and statistics on services counts in CCBHCs and other mental health facilities, with breakdowns by urban and rural areas.
Author(s): Aaron P. Smith, Jeffrey Talbert
Date: 05/2025
Sponsoring organization: Rural and Underserved Health Research Center
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How Does Cost Affect Access to Healthcare?
Explores trends in how costs affect access to healthcare using data from the National Health Interview Survey (NHIS) through 2023. Covers the percentage of adults who delayed or went without care due to cost, including insulin users who rationed insulin due to costs. Presents data by income level, health status, insurance status, and urban/rural residence.
Author(s): Shameek Rakshit, Matthew McGough, Lynne Cotter, Gary Claxton
Date: 04/2025
Sponsoring organizations: KFF, Peterson Center on Healthcare
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Explores trends in how costs affect access to healthcare using data from the National Health Interview Survey (NHIS) through 2023. Covers the percentage of adults who delayed or went without care due to cost, including insulin users who rationed insulin due to costs. Presents data by income level, health status, insurance status, and urban/rural residence.
Author(s): Shameek Rakshit, Matthew McGough, Lynne Cotter, Gary Claxton
Date: 04/2025
Sponsoring organizations: KFF, Peterson Center on Healthcare
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Rebuilding Maternal Health Access in Western North Carolina: Addressing Critical Gaps Amplified by Hurricane Helene
Discusses the impact of Hurricane Helene on maternal health in rural North Carolina. Focuses on maternal healthcare workforce shortages, access issues in isolated areas, maternal morbidity and mortality, rural health disparities, and more. Offers suggestions to improve rural maternal health in North Carolina, including enhancing data collection, strengthening infrastructure and access, and addressing the social determinants of health.
Author(s): Jennifer Runkle, Maggie Sugg
Citation: North Carolina Medical Journal, 86(1)
Date: 04/2025
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Discusses the impact of Hurricane Helene on maternal health in rural North Carolina. Focuses on maternal healthcare workforce shortages, access issues in isolated areas, maternal morbidity and mortality, rural health disparities, and more. Offers suggestions to improve rural maternal health in North Carolina, including enhancing data collection, strengthening infrastructure and access, and addressing the social determinants of health.
Author(s): Jennifer Runkle, Maggie Sugg
Citation: North Carolina Medical Journal, 86(1)
Date: 04/2025
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Changes in the Availability of Inpatient Psychiatric Beds Across Rural and Urban Areas, 2012-2021
Policy brief describing numbers of Critical Access Hospitals and rural Prospective Payment System (PPS) hospitals providing inpatient psychiatric care, and comparing these to urban PPS hospitals. Also examines psychiatric unit closure rates and the effect on access to behavioral health services in rural areas.
Author(s): John Gale, Zachariah T. Croll, Jamar Croom, Yvonne Jonk
Date: 04/2025
Sponsoring organization: Maine Rural Health Research Center
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Policy brief describing numbers of Critical Access Hospitals and rural Prospective Payment System (PPS) hospitals providing inpatient psychiatric care, and comparing these to urban PPS hospitals. Also examines psychiatric unit closure rates and the effect on access to behavioral health services in rural areas.
Author(s): John Gale, Zachariah T. Croll, Jamar Croom, Yvonne Jonk
Date: 04/2025
Sponsoring organization: Maine Rural Health Research Center
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Job Assessments and the Anticipated Retention of Behavioral Health Clinicians Working in U.S. Health Professional Shortage Areas
Examines perspectives of behavioral health clinicians working in Mental Health Professional Shortage Areas (mHPSAs) related to their anticipated retention in an mHPSA. Examines 2016-2023 survey feedback from 2,587 respondents regarding their anticipated retention, with data breakdowns according to demographics, professional characteristics, education debt, and rural versus urban location.
Author(s): Donald E. Pathman, Lisa de Saxe Zerden, Thomas R. Konrad, et al.
Citation: BMC Health Services Research, 25, 592
Date: 04/2025
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Examines perspectives of behavioral health clinicians working in Mental Health Professional Shortage Areas (mHPSAs) related to their anticipated retention in an mHPSA. Examines 2016-2023 survey feedback from 2,587 respondents regarding their anticipated retention, with data breakdowns according to demographics, professional characteristics, education debt, and rural versus urban location.
Author(s): Donald E. Pathman, Lisa de Saxe Zerden, Thomas R. Konrad, et al.
Citation: BMC Health Services Research, 25, 592
Date: 04/2025
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Promoting the Health of Migrant Seasonal Agricultural Workers in Rural Minnesota Using a Whole-Person Health Approach: A Pilot Project
Discusses the efficacy of a whole-health assessment of migrant and seasonal agricultural workers (MSAWs) at identifying community strengths and challenges pertaining to physical, emotional, social, and economic health. Highlights the University of Minnesota comprehensive whole-health assessment criteria and details the implementation, uptake, and results.
Author(s): Shahidali Jaffer, Robin Austin, Jonathan D. Kirsch
Citation: Frontiers in Public Health, 13, 1518686
Date: 04/2025
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Discusses the efficacy of a whole-health assessment of migrant and seasonal agricultural workers (MSAWs) at identifying community strengths and challenges pertaining to physical, emotional, social, and economic health. Highlights the University of Minnesota comprehensive whole-health assessment criteria and details the implementation, uptake, and results.
Author(s): Shahidali Jaffer, Robin Austin, Jonathan D. Kirsch
Citation: Frontiers in Public Health, 13, 1518686
Date: 04/2025
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Rural Emergency Medical Services Perspectives on Improving Acute Stroke Care: A Qualitative Study
Examines barriers and facilitators to timely and high-quality acute stroke care in rural communities via interviews with 12 rural EMS professionals in North Carolina. Discusses topics including comprehensive stroke assessment, destination decision protocols, communication between EMS and hospital staff, transport distances, limited staffing, and more.
Author(s): Emma N. Johnson, Mahesh V. Pinapaka, Mary E. Grewe, et al.
Citation: Prehospital Emergency Care, 29(8), 1123–1131
Date: 04/2025
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Examines barriers and facilitators to timely and high-quality acute stroke care in rural communities via interviews with 12 rural EMS professionals in North Carolina. Discusses topics including comprehensive stroke assessment, destination decision protocols, communication between EMS and hospital staff, transport distances, limited staffing, and more.
Author(s): Emma N. Johnson, Mahesh V. Pinapaka, Mary E. Grewe, et al.
Citation: Prehospital Emergency Care, 29(8), 1123–1131
Date: 04/2025
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Mapping Maternity Care Deserts: Driving Distance and Health Outcomes in North Carolina
Examines the relationship between maternity care deserts in North Carolina and maternal and infant health. Utilizes 2016-2021 hospitalization records to examine travel distance to care and health outcomes such as cesarean delivery rates, severe maternal morbidity, and hypertension. Discusses maternal health access issues across rural-urban commuting (RUCA) codes.
Author(s): Margaret Sugg, Shishir Shakya, Sarah Ulrich, et al.
Citation: Journal of Rural Health, 41(2)
Date: 04/2025
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Examines the relationship between maternity care deserts in North Carolina and maternal and infant health. Utilizes 2016-2021 hospitalization records to examine travel distance to care and health outcomes such as cesarean delivery rates, severe maternal morbidity, and hypertension. Discusses maternal health access issues across rural-urban commuting (RUCA) codes.
Author(s): Margaret Sugg, Shishir Shakya, Sarah Ulrich, et al.
Citation: Journal of Rural Health, 41(2)
Date: 04/2025
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Mapping Disparities in Access to Lecanemab in Georgia
Analyzes access to Alzheimer's disease (AD) treatments in Georgia. Analyzes location of and drive times to lecanemab infusion sites and amyloid positron emission tomography (PET) scan facilities across the state. Discusses issues of access in rural counties.
Author(s): Niying Li, Samruddhi Nandkumar Borate, Kai Zhang, et al.
Citation: Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 21(4)
Date: 04/2025
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Analyzes access to Alzheimer's disease (AD) treatments in Georgia. Analyzes location of and drive times to lecanemab infusion sites and amyloid positron emission tomography (PET) scan facilities across the state. Discusses issues of access in rural counties.
Author(s): Niying Li, Samruddhi Nandkumar Borate, Kai Zhang, et al.
Citation: Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 21(4)
Date: 04/2025
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