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RHRC Projects 2013-2014

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Obstetric Care Practice Models and Quality in Rural Hospitals
Limited research explores obstetric care practice models in the context of rural hospitals in the U.S., including whether such emerging collaborative models have been adopted or implemented in rural hospitals and if so, how such models may be related to quality of care in these settings. The purpose of this project is to examine current obstetric practice models in rural hospitals and to assess the prospects for implementation of new policy recommendations for reducing primary cesarean rates and non-medically indicated inductions of labor in rural hospitals.This project will use hospital discharge data on all births from the 2010 HCUP Statewide Inpatient Data for nine states and 2010 American Hospital Association Annual Survey, as well as primary data from a survey of rural hospitals providing obstetric services. Statistical analysis will comprise multivariate linear and logistic regression models.

The Impact of Private Sector Quality Initiatives on Rural Providers and Patients
Much of the attention on strategies to improve quality performance among health care providers has been focused on federal initiatives regarding public reporting of quality measures and the use of “pay-for-performance” financial incentives. However, private sector quality initiatives could potentially have a significant impact on the quality of rural healthcare. The purpose of this project is to assess the impact of private sector quality reporting and quality improvement initiatives on rural providers and on the quality of care provided to rural patients. This qualitative study will involve a review of the literature and primary data collection using survey interviews with insurers/health plans in multiple states with significant rural populations. 

Are Part D Plans Meeting the Needs of Rural Medicare Beneficiaries?
It is unclear how variation in the number and types of Part D plans in rural versus urban areas has affected prescription coverage.  The purpose of this project is to assess whether the Medicare Part D prescription drug plans available in rural counties are sufficient to meet the needs of rural Medicare beneficiaries, and to identify what changes would help the Part D program better address the needs of rural beneficiaries. Descriptive and multivariate statistics will be used to analyze the plans available to Medicare beneficiaries by level of rurality; differences in enrollment rates by regions and levels of rurality; beneficiaries’ enrollment decisions; and differences in satisfaction with prescription drug plans and pharmacy access.

Integrated Organizational Relationships and Rural Health Providers
Rural providers face many challenges to participating in integrated organizational relationships. Consequently, research on rural provider participation in these relationships has been limited. The purpose of this project is to assess the types of integrated organizational relationships that include participation by rural health providers and to understand their potential relationship to new organizational initiatives stimulated by health care reform. This project will use secondary data to identify models of care coordination and integration employed in rural communities and to measure the probability that various rural and urban provider organizations are likely to participate in new marketplace relationships over time. Empirical analysis will include descriptive statistics as well as regression models (e.g., probit and logistic regressions).