Rural Healthy People 2010: Identifying Rural Health Priorities and Models for Practice

Gamm, Larry; Hutchison, Linnae; Bellamy, Gail; Dabney, Betty J.

doi:10.1111/j.1748-0361.2002.tb00869.x

Cited by 153 publications

(177 citation statements)

References 13 publications

(4 reference statements)

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“…2,[11][12][13] There is also concern that community-level factors including living environment, community context, distance to providers, and local economic prospects could influence hospital mortality. 14 -16 Community factors such as the number of primary care doctors per capita, and the average proportion of high-risk, long-stay nursing home patients have been demonstrated to explain over half of the variability in hospital readmission rates between counties, but it is not clear how these factors relate to recent trends in hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

Worsening Rural-Urban Gap in Hospital Mortality

2017

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Background: One out of every 5 Americans live in rural communities. Rural Americans have higher rates of early and preventable deaths outside of the hospital than their urban counterparts. How rurality relates to hospital mortality is unknown. We sought to determine the association between rural versus urban residence and hospital mortality.Methods: This is a retrospective observational study of 4,412,942 nonmaternal, nonneonatal hospitalizations in 2008, and 3899,464 nonmaternal, nonneonatal hospitalizations in 2013 using all-payer, all-age data from the National Inpatient Sample of the Health care Cost and Utilization Project. Using multivariable logistic regression, we report the association between rural versus urban location of residence and hospital mortality, adjusting for chronic disease burden, age, income, and insurance status.Results: The unadjusted probability of hospital mortality for urban patients decreased from 2.51% (95% CI ,

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Section: Discussionmentioning

confidence: 99%

Worsening Rural-Urban Gap in Hospital Mortality

2017

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“…6,7 Rural patients are also more likely to be uninsured, poor, and chronically ill. 8,9 Disparities in morbidity and mortality between metropolitan and rural cardiovascular patients have increased in recent years. 9 One proposed explanation is that rural populations have certain behaviors, attitudes, and access challenges that may contribute to their heightened risk of coronary heart disease, myocardial infarction and HF. These include poor adoption of lifestyle habits associated with decreasing heart disease, such as, smoking cessation, low-fat diets, exercise, and increased perception of heart disease risk, especially among older rural women.…”

mentioning

confidence: 99%

Correlates of Quality of Life in Rural Patients With Heart Failure

Nesbitt

Doctorvaladan

Southard

et al. 2014

Circ: Heart Failure

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Background There is abundant research indicating poor physical, psychological and social functioning of patients with chronic heart failure (HF), a reality that can lead to poor health related quality of life (HRQoL). Little is known about the experience of rural HF patients. Methods and Results This study was part of a randomized clinical trial titled Rural Education to Improve Outcomes in Heart Failure (REMOTE-HF) designed to test an education and counseling intervention to improve self-care in patients with HF. We evaluated 612 rural patients. Multiple validated questionnaires were administered to assess patient perceptions of health and health literacy. Baseline factors were collected and compared to baseline QoL measures only. Patients’ HRQoL was assessed using the Minnesota Living with Heart Failure (MLWHF) scale. The data were analyzed using a general linear model to test the association of various patient characteristics with quality of life in rural patients with HF. Patients were 65.8 (+12.9) years of age. The majority were male (58.7%), married (56.4%) and had completed a high school education (80.9%). Factors associated with reduced quality of life amongst this population include: geographic location, younger age, male gender, higher NYHA class, worse HF knowledge, poorer perceived control and symptoms of depression or anxiety. The data provided no evidence of an association between left ventricular ejection fraction and quality of life. Conclusions This study of rural HF patients confirms previously identified factors associated with perceptions of quality of life. However, further study is warranted with an urban control group.

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“…Access to quality health services has been identified as a top-ranking rural health priority (Gamm, Hutchison, Bellamy, & Dabney, 2002). However, residents of rural areas have been found to experience greater challenges with access following the Year 2000 changes in reimbursement for home health from cost-based to prospective payment system (PPS) (Egan & Kadushin, 2002;Sutton, 2005).…”

Section: Mezzosocial or Organizational Domainmentioning

confidence: 97%

Rural–Urban Differences in End-of-Life Care: Implications for Practice

Waldrop

Kirkendall

2010

Social Work in Health Care

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Most older adults with advanced illnesses express the wish to die at home. Home-based care from home health and hospice agencies makes this possible, but there are great geographic variations in utilization. Interviews and focus groups with key constituents in home health and hospice agencies across the 8-county region of Western New York State were used to explore how rural-urban location and agency type (home health or hospice) influence variations in end-of-life care. Emergent themes were: Rural-Urban Differences (geographic challenges, market forces, and programming issues) and End-of-life Care Issues (macrosocial, mezzosocial, and microsocial factors). Implications for social work practice are discussed.

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Rural Healthy People 2010: Identifying Rural Health Priorities and Models for Practice

Cited by 153 publications

References 13 publications

Worsening Rural-Urban Gap in Hospital Mortality

Worsening Rural-Urban Gap in Hospital Mortality

Correlates of Quality of Life in Rural Patients With Heart Failure

Rural–Urban Differences in End-of-Life Care: Implications for Practice

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