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Rural Health Information Hub

Rural Health
Resources by Topic: Healthcare needs and services

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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Reflections of Rural Primary Care Physicians on the Impact of the COVID-19 Pandemic: A Qualitative Study
Describes the impact of the COVID-19 pandemic on rural primary care physicians' relationships with patients, other physicians, clinic staff, and their communities via interviews conducted between Oct 2022 and April 2023 with 12 Wisconsin physicians. Discusses elements including challenges in implementing new clinical practices, impacts of beliefs about the pandemic, strategies and coping mechanisms, and availability of staff and other resources.
Author(s): Mary F. Henningfield, Keelin McHugh, Sarina Schrager
Citation: BMC Primary Care, 26, 160
Date: 05/2025
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Nonfatal Injury Emergency Department Visits and Inpatient Hospitalizations Among Persons Under Age 65 With an Intellectual and Developmental Disability or Deaf or Hard of Hearing Disability
Analyzes disparities in emergency department and inpatient hospitalization among people with intellectual and developmental disabilities (IDD), people who are deaf or hard of hearing (DHH), and those without IDD or DHH. Utilizes Kentucky ED and inpatient discharge data from 2019 to 2023. Breaks down data by demographic category, including metropolitan or nonmetropolitan dwelling.
Author(s): Terry L. Bunn, Jacqueline Seals, Dana Quesinberry, Alaina Murphy, Julia F. Costich
Citation: Injury Epidemiology, 12, 27
Date: 05/2025
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Evaluation of the Primary Care First Model: Third Annual Report
Provides an overview of the Primary Care First (PCF) model, which aims to enhance primary care and move primary care practitioners toward value-based payment. Describes the PCF model implementation experiences for Cohort 1 and Cohort 2 practices through 2023. Explores the characteristics of practices and payers that continued to participate in the PCF model compared to those who left. Examines the role that the PCF Model's incentives and supports played in the strategies and practices adopted to improve care delivery and how the trajectory of these strategies and activities practices have transformed over time. Estimates the impact of the PCF Model on Medicare fee-for-service (FFS) expenditures and service use, including acute hospitalizations. Estimates the impacts of the model on a set of seven leading indicators to provide an early assessment of whether care delivery changes are resulting in meaningful early outcome changes.
Additional links: Executive Summary, Findings at a Glance
Date: 05/2025
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Continuity of Pain Clinic Care Among Rural and Urban Veterans
Presents a study exploring the differences in continuity of pain care through the Veterans Health Administration (VHA) for rural and urban veterans. Breaks down data by age, sex, pain severity, and behavioral health disorders, among other measures.
Author(s): Katherine Hadlandsmyth, Rena E. Courtney, Jenna L. Adamowicz, et al.
Citation: Journal of Rural Health, 41(2), e70031
Date: 05/2025
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Arkansas's Shifting Rural-Urban Divide: Healthcare Access Issues
Provides data on shortages of primary care physicians and dentists in rural and urban areas in Arkansas, and discusses high vulnerability to closure among rural hospitals in the state.
Date: 05/2025
Sponsoring organization: Arkansas Center for Health Improvement
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Delaying Screening Until Covered? Changes in Lung Cancer Screening at the Age of Nearly-Universal Medicare Insurance
Examines the impact of first-time screening of lung cancer at age 65, the age of nearly universal Medicare insurance coverage. Utilizes 2015-2020 American College of Radiology's Lung Cancer Screening Registry data to analyze differences in screening rates between ages 60-64 and 65-69. Includes additional data breakdowns such as patient demographics, smoking behaviors, eligibility for screening, and rural versus non-rural patient location.
Author(s): Marcelo C. Perraillon, Adam Warren, Lenka Goldman, Jamie L. Studts, Rebecca M. Myerson
Citation: Health Services Research
Date: 05/2025
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Longitudinal Lipidomic Profile of Subclinical Peripheral Artery Disease in American Indians: The Strong Heart Family Study
Examines associations between lipid species and peripheral artery disease (PAD) among 1,886 American Indian members of tribal communities who participated in the Strong Heart Family Study. Provides data on the connection between specific lipid species and PAD, coronary heart disease, and other clinical factors.
Author(s): Mingjing Chen, Guanhong Miao, Mary J. Roman, et al.
Citation: Preventing Chronic Disease, 22, 240220
Date: 05/2025
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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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Rural and Urban Differences in Suicide in the United States, 2018-2021
Highlights the rates of suicide across the U.S. from 2018-2021 in rural and urban areas. Discusses some of the geographic and demographic characteristics that correlate with higher rates of suicide. Breaks down data by year, demographics, Census and HHS regions, and rural versus urban location. Makes policy recommendations based on the report's findings.
Author(s): Qian Huang, Nicole Galler, Michael Meit, Amy Wahlquist
Date: 05/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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