Rural Health Clinic Efficiency and Effectiveness: Insight from a Nationwide Survey

“…Census Bureau (2009, 2010). The sources of data on operational characteristics were a survey distributed by mail to all RHCs existing in 2007 (Ortiz et al , 2011), and the Medicare Cost Report (U.S. Department of Health and Human Services, CMS, 2007, 2008b).…”

Section: Methodsmentioning

confidence: 99%

“…Sources of demographic data describing the counties in which RHCs are located were the Area Resource File Access System (Bureau of Health Professions, 2007) and the U.S. Census Bureau (2009; 2010). The sources of data on operational characteristics were a survey distributed through mail to all RHCs existing in 2007 (Ortiz et al ., 2011), and the Medicare Cost Report (U.S. Department of Health and Human Services, CMS, 2007; 2008b).…”

Section: Methodsmentioning

confidence: 99%

“…From the study population, we developed a study panel consisting of all RHCs continuously in operation during 2006 and 2007. The demographic and operational data were merged to form two data sets: one for the entire study panel and another for the 2009 survey data (Ortiz et al ., 2011). Descriptive statistics were then calculated to describe three aspects of RHCs: demographics of RHC service communities, RHC geographic distribution, and RHC operational characteristics.…”

Section: Methodsmentioning

confidence: 99%

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Trends in Rural Health Clinics and needs during U.S. health care reform

Ortiz

Meemon

Zhou

et al. 2012

Prim Health Care Res Dev

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Aim Rural Health Clinics (RHCs) are primary care clinics certified through Medicare and Medicaid to provide health care to the medically underserved in rural areas of the United States. The purpose of this paper is to describe how the characteristics of RHCs have either changed or remained stable over a 10-year period in the past: from the late 1990s to 2007. In addition, it is also to describe some of the outstanding needs of RHCs as they navigate the transitions of U.S. health care reform. Methods Using a panel of RHCs continuously in existence from 2006 through 2007, we calculated and compared statistics with corresponding statistics from the literature. We describe the geographic distribution of RHCs, demographics of their counties of location, and characteristics of RHC structure and staffing. We also explore the implications of the recently enacted health reform law (the Patient Protection and Affordable Care Act or ACA) for RHCs, and the improvements that RHCs need as it is implemented. Findings By the end of the study period the highest percentages of RHCs were in the South and Midwest, the percentage of RHCs in the West had grown, and that in the South had declined. RHCs served counties with increasing proportions of individuals below poverty and Hispanics/Latinos. The percentage of independent clinics had grown, as had the percentage of for-profit clinics. Finally, the percentage of nurse practitioner full-time equivalents had grown as a proportion of the total for three providers. Conclusions In investigating the performance of RHCs, many managerial and operational factors are not well understood. It is imperative that RHCs gather the information that could help them maximize the elements of their performance that would keep them financially stable. In addition, a broader awareness of the unique challenges that RHCs face in this era of health care reform is needed.

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“…Use of disease management programs, use of interdisciplinary teams, process efficiency, participation in integrated health systems, poverty rates, percentage of elderly, and geographic location were not related to effectiveness. 7 …”

Section: Introductionmentioning

confidence: 99%

Organizational and Environmental Correlates to Preventive Quality of Care in US Rural Health Clinics

Agiro

Wan

Ortiz

2012

J Prim Care Community Health

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Purpose To identify organizational and environmental correlates to rural health clinics’ preventive quality of care in the United States. Design A retrospective observational cohort study design was applied under Donabedian’s Structure-Process-Outcome framework. Three structure measures of care (proportion of nonphysicians, absence of physicians, and provider affiliation) and three measures of process (total clinical visits, prevention use for congestive heart failure and diabetes) were used as explanatory variables. Five environmental correlates were included. The Centers for Medicare and Medicaid Services National Medicare Chronic Care Condition Data Warehouse for 2007 was used to obtain clinical data. Preventive quality of care outcomes were measured through Agency for Healthcare Research and Quality prevention quality indicators. The indicators were risk adjusted for age, sex, race, severity, and comorbidity of patients. Methods Structural equation modeling with maximum likelihood estimation was used. Findings Provider affiliation (P = .03), absence of physicians (P = .007), and higher proportion of nonphysicians (P = .007) were negatively related to preventive quality of care. Lower cause-specific mortality rate at the county level as compared to the United States average (P = .05) and rural location (P = .001) were positively related to quality of care. Implications The results of the study showed the need to attract and retain physicians in rural health clinics. The positive relationship between rural location and quality of care reflects more on the limited access to hospitals in remote areas.

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Rural Health Clinic Efficiency and Effectiveness: Insight from a Nationwide Survey

Cited by 9 publications

References 16 publications

Availability of New Medicaid Patient Appointments and the Role of Rural Health Clinics

Availability of New Medicaid Patient Appointments and the Role of Rural Health Clinics

Trends in Rural Health Clinics and needs during U.S. health care reform

Organizational and Environmental Correlates to Preventive Quality of Care in US Rural Health Clinics

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