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Healthcare Access in Rural Communities – Resources

Selected recent or important resources focusing on Healthcare Access in Rural Communities.

Leveraging Health Care Reform to Accelerate Nurse Practitioner Full Practice Authority
Presents a descriptive study of legislation from 1994 to 2016 impacting the scope of practice for nurse practitioners (NPs). Discusses how supporting full practice authority (FPA) where physician involvement is not required can lessen the concern over the lack of primary care providers by allowing NPs to offer comprehensive healthcare services to rural and vulnerable patients. Identifies barriers and limitations to FPA.
Author(s): Heather M. Brom, Pamela J. Salsberry, Margaret Clark Graham
Citation: Journal of the American Association of Nurse Practitioners, 30(3), 120-130
Date: 03/2018
Type: Document
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State-Based Marketplaces Outperform Federally-Facilitated Marketplaces
Compares state-based and federally-facilitated health insurance marketplaces from 2016-2018 related to changes in premiums and number of insurers. Includes some information on nonmetropolitan counties, with the appendix providing charts comparing carrier count in metro and nonmetro counties.
Additional links: Appendix
Author(s): Jane M. Zhu, Daniel Polsky, Yuehan Zhang
Date: 03/2018
Type: Document
Sponsoring organization: Leonard Davis Institute of Health Economics
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Competition and Premium Costs in Single-insurer Marketplaces: A Study of Five Rural States
Examines participation in the individual health insurance market from 2010, before the passage of the Affordable Care Act (ACA), through 2017 and analyzes premium changes in 5 rural states with a single-insurer health insurance marketplace. States include Alabama, Alaska, Oklahoma, South Carolina, and Wyoming.
Author(s): Jon R. Gabel, Heidi Whitmore, Matthew Green, Sam Stromberg
Date: 03/2018
Type: Document
Sponsoring organization: Commonwealth Fund
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Geographic Access to Mammography Facilities and Frequency of Mammography Screening
Explores a study on the role location plays in mammography utilization. Draws data from the Wisconsin Women's Health Study and uses Rural Urban Commuting Area (RUCA) codes to determine the distance women would have to travel to a mammography facility.
Author(s): Patricia I. Jewett, Ronald E. Gangnon, Elena Elkin, et al.
Citation: Annals of Epidemiology, 28(2), 65-71
Date: 02/2018
Type: Document
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Distance and Networks: A Regional Analysis of Health Insurance Marketplaces
Examines whether Rating Area design and network adequacy standards have contributed to the level of success of Health Insurance Marketplaces (HIMs) in rural areas in terms of enrollment and affordability. Uses 2015-2016 data from 15 Midwestern states, on participation, premiums, and enrollment success.
Author(s): Abigail R. Barker, Alena R. Wheeler, Leah M. Kemper, Timothy D. McBride, Keith J. Mueller
Date: 01/2018
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Access to Care: Populations in Counties with No FQHC, RHC, or Acute Care Hospital
Findings brief focusing on the 3 main facility types providing primary care in rural areas and examining how many people will likely have limited access to primary care based on their locations. Includes statistics on numbers of people living in counties without these facilities, with breakdowns by 9 census divisions.
Author(s): Meagan Clawar, Randy Randolph, Kristie Thompson, George H. Pink
Date: 01/2018
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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The Differential Effects of Rural Health Care Access on Race-Specific Mortality
Investigates the association between race-specific rural mortality and the health infrastructure of rural counties using data from the National Center for Health Statistics Compressed Mortality File (2008-2012); county-level demographic, socioeconomic, and healthcare indicators from Health Resources and Services Administration's Area Health Resource File; and the U.S. Census. Covers the rural public health infrastructure index that indicates the presence or absence of 4 types of healthcare measures: public health employees, Critical Access Hospitals (CAHs) or rural referral centers, Rural Health Clinics (RHCs), and emergency departments within counties.
Author(s): Jeralynn Cossman, Wesley James, Julia Kay Wolf
Citation: SSM Population Health, 3, 618-623
Date: 12/2017
Type: Document
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ESRD Facility Characteristics by Rurality and Risk of Closure
Profiles rural end-stage renal disease (ESRD) facilities, especially the ones at greatest risk for closure. Examines the facilities' characteristics, quality of care, and distance their patients would need to travel if the facilities should close. Features statistics with breakdowns by urban and rural locations.
Author(s): Jan M. Eberth, Fozia Ajmal, Kevin Bennett, Janice C. Probst
Date: 11/2017
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Emerging Strategies to Ensure Access to Health Care Services: Urgent Care Centers
Outlines a strategy to improve access to and the delivery of healthcare services by creating urgent care centers. Offers federal policy solutions to promote the effective adoption of the urgent care center model.
Additional links: Is the Urgent Care Center the Right Strategy for your Community?
Date: 11/2017
Type: Document
Sponsoring organization: American Hospital Association
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Access To Obstetric Services In Rural Counties Still Declining, With 9 Percent Losing Services, 2004-14
Results of a study identifying gaps in the availability of hospital-based obstetric services in rural America, and providing evidence of disparities in local access to obstetric services in vulnerable rural communities. Includes statistics on percentages of rural counties by status of hospital obstetric services from 2004–14, with breakdowns by micropolitan or noncore location, and a county-level map with shadings indicating full closure, continuous services, or no services.
Author(s): Peiyin Hung, Carrie E. Henning-Smith, Michelle M. Casey, Katy B. Kozhimannil
Citation: Health Affairs, 36(9), 1663-1671
Date: 09/2017
Type: Document
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Last Updated: 1/3/2024