bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Economic Cost of Farm Tractor Rollover Deaths in New York
Authors: Kelsey Timothy W. 
Published: April 2008

ABSTRACT:Farm tractor rollovers account for one quarter of all fatal farm injuries, but their economic impact has not been studied previously. This study surveyed surviving family members of people killed between 1985 and 1987 in New York farm tractor rollovers and found the average expected income lost by each death was $243,615 (response rate=46%, N=12). Fatal farm tractor rollovers may cost New York more than $2 million a year in lost income. Nonfarmers account for 33 percent of these rollover deaths. These nonfarmers were not on a farm and were not doing farm work at the time of the fatal injury. Policy responses to the dangers of farm tractors should consider the risks to nonfarmers and should be cognizant of the costs that could be averted.
Physician Staffing of Small Rural Hospital Emergency Departments: Rapid Change and Escalating Cost
Authors: Williamson Harold A. , Rosenblatt Roger A. , Hart L. Gary 
Published: April 2008

ABSTRACTWe surveyed all 37 rural Washington state hospitals with fewer than 100 beds to determine how rural emergency departments are staffed by physicians and to estimate rural hospital payments for emergency department physician services. Only five hospital emergency departments (14%) were still covered by the traditional rotation of local practitioners and billed on a fee‐for‐service basis. Ten hospitals (27%) paid local private practitioners to provide emergency department coverage. Twelve other hospitals (32%) hired visiting emergency department physicians to cover only weekends or evenings. The remaining 10 rural emergency departments (27%) were staffed entirely by external contract physicians. Thus, 86 percent of rural hospitals contracted for emergency department coverage, and 59 percent obtained some or all of this service from nonlocal physicians. Most of the 32 hospitals with some form of contracted services have changed to this emergency department coverage in the last few years. The cost of these services is high, particularly for the smallest hospitals that have fewer than eight emergency department visits per day and pay physician wages of nearly $100 per patient visit. Emergency staffing responsibility has shifted from local practitioners to the hospital administrators because of rural physician scarcity and a desire to improve quality and convenience. The cost of these changes may further undermine the economic viability of the smaller rural hospitals.
A Descriptive Analysis of Health Insurance Coverage Among Farm Families in Minnesota
Authors: Kralewski John E. , Liu Yuanli , Shapiro Janet 
Published: April 2008

ABSTRACT This paper reports the findings of a study of health insurance coverage and access to health services among farm families in Minnesota. The study included 1,482 families actively engaged in farming during 1989. While less than 10 percent of the population were uninsured during this period, the majority had limited coverage with high deductible and coinsurance provisions. Moreover, they were paying an estimated 15 to 20 percent more for their plans than a similar plan would have cost in the Minneapolis‐St. Paul, MN, area. With the exception of cost, satisfaction with health services was found to be very high, and there were few indications of access problems.
Job Satisfaction and Retention of Rural Community Health Nurses in North Dakota
Authors: Dunkin Jeri , Juhl Nyla , Stratton Terry , Geller Jack , Ludtke Richard 
Published: April 2008

ABSTRACTA correlation between job satisfaction and employment longevity has been demonstrated by a number of researchers. However, the measurable aspects of job satisfaction only partially explain an individual's tenure at a particular job. Information about the relationship between job satisfaction and retention of community health nurses in a rural state was provided by 258 community health nurses in North Dakota who responded to a mailed questionnaire. Job satisfaction assessment included measures of autonomy, task requirements, salary, benefits, rewards, professional status, organizational climate, and interpersonal interactions. Job satisfaction was analyzed by taking into account the individual importance of each component. While the majority (61%) of the responding nurses indicated that they expected to stay in their current jobs for a period of five years or more, they were dissatisfied with various aspects of their jobs. The greatest factor influencing the nurses’choice of current position was job availability, followed by preferences for the particular health care agencies or communities. These findings indicate that retention of rural nurses should focus on strategies that go beyond improving job satisfaction.
Nursing Supply and Characteristics in the Nonmetropolitan Areas of the United States: Findings from the 1988 National Sample Survey of Registered Nurses
Authors: Movassaghi Hormoz , Kindig David A. , Juhl Nyla , Geller Jack M. 
Published: April 2008

ABSTRACTThis study examines the supply and selected characteristics of nurses working in nonmetropolitan areas of the United States using the most recent data reported in the third national sample survey of registered nurses in 1988. Nursing supply is analyzed in terms of the ratio of registered nurses per 100,000 people for three standard nonmetropolitan census county size classifications and nine regional groupings of states. Seven dimensions relating to the educational background and current professional characteristics of registered nurses are studied. Findings indicate a notable difference in the ratio of nurses per population across county size and regions of the country. In terms of characteristics selected for this study, the educational background, salary gap, and time spent in various activities differentiate nurses in rural areas from those working in urban counties. Results of this study should be particularly relevant because a variety of educational, financial, and other incentives are being considered to address what is perceived to be a crisis in rural nursing availability.
The Relationship of Rural Clinical Rotations to Where Registered Nurses Practice
Authors: Gordon Hene T. , Denton Denise 
Published: April 2008

ABSTRACTAn objective of exposing health profession students to rural clinical experiences was to overcome problems of geographic maldistribution of health personnel. Nevertheless, little can be said about the impact of rural training rotations on the supply of health personnel in rural areas or on students’decisions about where to practice. To assess the relationship between rural clinical rotations and practice locales, surveys were administered to all applicants taking registered nurse exams in Arizona in July 1990, February 1991, and July 1991.The students most likely to be working in rural locations were rural high school graduates with rural clinical experience during nursing school. Students who were urban high school graduates with rural clinical experience were only slightly less likely to locate in rural areas. Rural and urban high school graduates with no rural clinical experience were far less likely to choose rural practice. Rural rotations were associated with rural job selection only if students attended rural educational programs.
Meeting the Health Care Needs of Rural Elderly: Client Satisfaction with a University‐Sponsored Nursing Center
Authors: Giltinan Janice M. , Murray Karen T. 
Published: April 2008

ABSTRACTResponding to health care needs of the elderly has presented great challenges for health care professionals. These problems are compounded in rural communities by physical and social isolation, increased poverty, and lack of transportation. An innovative approach to meeting health needs of rural elderly is through nursing centers. Through an emphasis on health promotion and maintenance of optimal level of functioning, these primary health care facilities can foster independence and self‐care for this targeted population. In addition, nursing centers serve as clinical sites for student learning experiences and settings for nursing research.This article focuses on a nursing center established at Edinboro University of Pennsylvania (EUP), which tailors its services to the elderly living in Edinboro. Results of a client satisfaction survey, based on the Risser Patient Satisfaction Instrument, are described in addition to patterns of nursing center usage, general categories of care, teaching interventions, referrals, counseling, and frequency of visits. Findings from the survey indicated a general high client satisfaction level with nursing care received at the center. Discussion also includes plans to expand services to elderly in the community through home visits.
Reaching Children of the Uninsured and Underinsured in Two Rural Wisconsin Counties: Findings from a Pilot Project
Authors: Clarridge Brian R. , RN Beverly J. Larson , Newman Kathleen M. 
Published: April 2008

Abstract: Debates about the accessibility, costs, and coverages of health care for the population at large have recently accelerated. This paper addresses some of the demographic, health, and fiscal ramifications of creating a preventive health care bridge to children in uninsured and underinsured families in two rural Wisconsin counties.The study findings revealed that the initial health status of children making a preventive health visit under a minimal copayment plan was noticeably worse than the status of those who had the free Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program available to them on a more or less continual basis. Upon their first visit, the children who did not have access to a free EPSDT program had a greater number of medical and dental health problems and fewer preventive dental care visits than their EPSDT contemporaries. Beyond a greater number of problems, however, we found no noticeable differences between the two groups in the types of health problems present (i.e. the clinical distribution of the problems was similar across the two groups). This paper also contrasts referral completion rates and rates of diagnostic confirmation of identified problems between the two groups. Finally, we provide estimates of the cost of coverage for each unprotected child.
Differences in the Use of Health Services by Metropolitan and Nonmetropolitan Elderly
Authors: Himes Christine L. , Rutrough Thyne S. 
Published: April 2008

ABSTRACT:This study examined the importance of place of residence on the elderly's use of health services through Andersen's framework of health service utilization. The study found that nonmetropolitan elderly, both farm and nonfarm, make fewer physician visits than their metropolitan counterparts. This difference is not explained by differences in their predisposing or need characteristics. No residential differences were found in the number of short‐term hospital stays or in the number of days of bed disability. No evidence was found that nonmetropolitan elderly substitute days of bed disability for physician care or for hospital stays. Also, little residential variation was found in the effect of predisposing, enabling, and need factors on physician use. The most likely explanation for the observed differences in physician use is the shortage of physicians in nonmetropolitan areas. However, without the ability to attach contextual information to national data on health status and service use, the relative importance of access to services cannot be adequately addressed.
Local Factors Affecting the Tendency to Bypass Local Hospitals for Inpatient Mental Health Care: An Exploratory Analysis
Authors: Goldsteen Raymond L. , Falcone David J. , Broyles Robert W. , Goldsteen Karen , Reilly Bernard J. 
Published: April 2008

ABSTRACT:Using the records of 2,171 rural residents of Illinois who received inpatient treatment for mental illness or substance abuse, this paper examines factors that influence the tendency to seek service from a distant rather than a local hospital. Results indicate that the age and insurance coverage of the individual, the per capita income of the community area, surrogates for the service orientation of the local hospital and the proximity of the patient's residence to an urban center are significant influences. With the exceptions of drug abuse requiring detoxification or other symptomatic treatment, drug abuse accompanied by comorbidity and psychosocial disorders, psychosis, and childhood disorders, the primary diagnosis of the individual failed to have a significant effect on the propensity to bypass local sources of inpatient treatment.
Birth Outcomes to Rural Illinois Residents: Is There a Crisis?
Authors: Rock Steven M. , Straub LaVonne A. 
Published: April 2008

ABSTRACT:In recent years, the supply of obstetric services in rural areas has been a concern. At the same time, the demand for such services has been affected by the reduction in population and economic base. This article explores the extent of these trends in Illinois and whether they have led to a deterioration in amount of prenatal care and birth outcomes. Using birth certificate and infant death data for residents of rural Illinois counties in 1983 and 1988, prenatal care and birth outcomes for each year are compared within rural areas and to the rest of the state, as well as between the two time periods. Although rural residents began prenatal care later, they obtained similar qualities of care as their urban counterparts. The data revealed no adverse impact on birth outcomes of residing in increasingly rural areas, nor was there a deterioration during the time period. An attempt was made to identify rural counties that lost providers and/ or facilities and those that gained them. Although such a classification scheme is subjective, similar results ensued. While indirect costs such as time and effort to obtain care may have increased, at 1988 levels of care availability there was no crisis in Illinois.
Health and Well‐Being of Childbearing Women in Rural and Urban Contexts
Authors: Walker Lorraine O. , Walker Misha L. , Walker Mary E. 
Published: April 2008

ABSTRACT:As part of the national focus on women's health issues, it is important to identify those health‐related characteristics of rural women that distinguish them from women living in urban settings. The aim of this study was to compare rural and urban childbearing women on socioeconomic characteristics, perceived stress, health‐related practices, illness symptoms, parenting confidence, and body weight. One hundred sixty‐five midwestern women responded to a health survey sent to them six months after childbirth. Rural women were younger and less educationally and economically advantaged compared to urban women. Before adjusting for these differences, rural women were less self‐actualized, more interpersonally isolated, and reported less healthy nutrition than urban women. These differences disappeared when socioeconomic differences were adjusted. Rural and urban mothers did not differ in most other areas, including perceived stress, parenting confidence, and body weight. Compared to national norms, the perceived stress levels of both rural and urban mothers were significantly higher than a probability sample of U.S. women. Findings support the role of socioeconomic factors as contributing to risk of poor health promotion among rural childbearing women.
Rural Primary Care Program Survival: An Analysis of Financial Variables
Authors: Shi Leiyu , Samuels Michael E. , Konrad Thomas R. , Porter Carol Q. , Stoskopf Carleen H. , Richter Donna L. 
Published: April 2008

ABSTRACT:This study examines the effect of financial characteristics of rural primary care programs on the probability of their continuing as federally funded entities. A randomly selected national cohort of rural primary care programs (n=162) was used to compare financial measures of programs that were continuing and those that were noncontinuing. Financial data were obtained from 1978‐1987 Bureau Common Reporting Requirements (BCRR) forms submitted to the Bureau of Health Care Delivery and Assistance of the Department of Health and Human Services as part of the requirement to receive federal grant support for the programs. The results emphasize the importance of both outside funding and increased level of self‐sufficiency in the continuation of rural primary care programs. Noncontinuing programs often suffer from both a lack of self‐sufficiency and a lack of outside funding, mostly from federal sources. To a lesser extent, the number of patients also affects the program's chance of continuation. From a policy perspective, government intervention is both necessary and likely if rural primary care programs are to succeed and fulfill their mission of providing primary care for the medically underserved who are primarily poor, uninsured, and unable to pay.
The Development of a State‐level Health Manpower Database Using an Employer‐based Survey: A Pilot Project
Authors: Bamberg Richard , Malvey Donna , Wainright Major Charles , Fottler Myron D. , Joiner Charles L. 
Published: April 2008

ABSTRACT:State health care reform may provide a better approach to meeting the health care needs of rural communities than does federal reform because the planning is closer to the needs of local communities. However, state health reform requires a health manpower database (along with other data) that includes all health occupations and such databases are often nonexistent. This study reports on one element of such a database–a survey of a wide range of rural health care employers covering the full range of health occupations in Alabama. Information on current and future employment of the most significant health occupations is reported here. It was found that the greatest numbers of new health personnel employees needed in the future were, in descending order, nursing assistants, registered nurses, licensed practical nurses, radiological technicians, specialist physicians, nurse practitioners, physical therapists, primary care physicians, and respiratory care therapists. While an employer survey has limitations and should be supplemented by data on community needs and health status indicators, it does provide useful information for planning educational programs to prepare health personnel.
Decomposing Area of Residence Differences in Multiple Regression Studies: The Relative Contributions of Independent Variables and Model Coefficients
Authors: Vogel W. Bruce , Dwyer Jeffrey W. , Barton Amy J. 
Published: April 2008

ABSTRACT:When rural/urban differences are found in health status or health care use, it is often desirable to identify those factors (such as age, social structure, income, etc.) that influence such differences. To this end, researchers often test rural/urban differences in age, social structure, income, etc., for statistical significance. Also, researchers commonly perform multivariate analyses (such as multiple regressions) to examine rural‐urban differences in the influence of various independent variables on the dependent variable of interest. Frequently, researchers discover: (1) statistically significant rural/urban differences in the independent variables (such as age, social structure, income, etc.) and (2) statistically significant rural/urban differences in the effects of these independent variables (i.e., statistically significant rural/urban differences in regression coefficients). The analysis typically stops here, without addressing the relative contributions of(1) and (2) to the rural/urban differences in the dependent variable.This paper argues that the relative contributions of(1) and (2) have important implications for the way policy‐makers address rural health problems. This paper presents a method for assessing the relative contributions of differences in the independent variables and differences in regression coefficients to observed differences in the dependent variable, and illustrates the application of the method by analyzing rural/urban differences in the risk of institutionalization (Dwyer, Barton, & Vogel, 1994).
A Logit Analysis of the Likelihood of Leaving Rural Settings for Registered Nurses
Authors: Pan Shihua , Dunkin Jeri , Muus Kyle J. , Harris T. Robert , Geller Jack M. 
Published: April 2008

Abstract: This study examined the net effects of individual and community factors on the likelihood of registered nurses leaving current jobs using a logit analysis. Based on data from a survey of 2,509 rural nurses, four separate models were estimated and compared: one for nurses in rural settings as a whole and the other three for nurses in hospitals, skilled nursing facilities, and community/public health agencies.Results of the general model indicated that nurses' marital status, age, position, income, job satisfaction, and satisfaction with the community were significant determinants of the likelihood of leaving current jobs. Job satisfaction was the most significant factor, followed by satisfaction with the community. Findings from the models for three different employment settings were similar to those of the general model. However, the significance of factors and their strength of effect on nurses' decisions to leave or stay in their current jobs differed across the three types of facilities.Based on these findings rural nursing administrators and policy‐makers should give priority to retention strategies that focus on improving the job environment. The development of different strategies for different groups of nurses (i.e., by age or marital status) and different types of facilities should increase the benefit/cost ratio. In addition, programs that involve rural health care agencies in community and economic development should be further explored as an avenue to increased nurse retention in rural areas.