Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review (Preprint)

2021 ◽  
Author(s):  
Michael Butzner ◽  
Yendelela Cuffee
Keyword(s):  
United States ◽  
Health Care ◽  
Rural Communities ◽  
Health Care Professionals ◽  
Health Care Service ◽  
The United States ◽  
Narrative Review ◽  
Future Research ◽  
Positive Outcomes ◽  
The Impact

BACKGROUND In rural communities, there are gaps in describing the design and effectiveness of technology interventions for treating diseases and addressing determinants of health. OBJECTIVE The aim of this study is to evaluate literature on current applications, therapeutic areas, and outcomes of telehealth interventions in rural communities in the United States. METHODS A narrative review of studies published on PubMed from January 2017 to December 2020 was conducted. Key search terms included telehealth, telemedicine, rural, and outcomes. RESULTS Among 15 included studies, 9 studies analyzed telehealth interventions in patients, 3 in health care professionals, and 3 in both patients and health care professionals. The included studies reported positive outcomes and experiences of telehealth use in rural populations including acceptability and increased satisfaction; they also noted that technology is convenient and efficient. Other notable benefits included decreased direct and indirect costs to the patient (travel cost and time) and health care service provider (staffing), lower onsite health care resource utilization, improved physician recruitment and retention, improved access to care, and increased education and training of patients and health care professionals. CONCLUSIONS Telehealth models were associated with positive outcomes for patients and health care professionals, suggesting these models are feasible and can be effective. Future telehealth interventions and studies examining these programs are warranted, especially in rural communities, and future research should evaluate the impact of increased telehealth use as a result of the COVID-19 pandemic.

Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review

10.2196/29575 ◽  
2021 ◽  
Vol 23 (8) ◽  
pp. e29575
Author(s):  
Michael Butzner ◽  
Yendelela Cuffee
Keyword(s):  
United States ◽  
Health Care ◽  
Rural Communities ◽  
Health Care Professionals ◽  
Health Care Service ◽  
The United States ◽  
Narrative Review ◽  
Future Research ◽  
Positive Outcomes ◽  
The Impact

Background In rural communities, there are gaps in describing the design and effectiveness of technology interventions for treating diseases and addressing determinants of health. Objective The aim of this study is to evaluate literature on current applications, therapeutic areas, and outcomes of telehealth interventions in rural communities in the United States. Methods A narrative review of studies published on PubMed from January 2017 to December 2020 was conducted. Key search terms included telehealth, telemedicine, rural, and outcomes. Results Among 15 included studies, 9 studies analyzed telehealth interventions in patients, 3 in health care professionals, and 3 in both patients and health care professionals. The included studies reported positive outcomes and experiences of telehealth use in rural populations including acceptability and increased satisfaction; they also noted that technology is convenient and efficient. Other notable benefits included decreased direct and indirect costs to the patient (travel cost and time) and health care service provider (staffing), lower onsite health care resource utilization, improved physician recruitment and retention, improved access to care, and increased education and training of patients and health care professionals. Conclusions Telehealth models were associated with positive outcomes for patients and health care professionals, suggesting these models are feasible and can be effective. Future telehealth interventions and studies examining these programs are warranted, especially in rural communities, and future research should evaluate the impact of increased telehealth use as a result of the COVID-19 pandemic.

Adolescent Birth Rates and Rural–Urban Differences by Levels of Deprivation and Health Professional Shortage Areas in the United States, 2017–2018

2021 ◽  
Vol 111 (1) ◽  
pp. 136-144
Author(s):  
Sylvester O. Orimaye ◽  
Nathan Hale ◽  
Edward Leinaar ◽  
Michael G. Smith ◽  
Amal Khoury
Keyword(s):  
United States ◽  
Rural Communities ◽  
Health Professional ◽  
Health Resources ◽  
The United States ◽  
Future Research ◽  
Birth Rates ◽  
Rural Counties ◽  
Adolescent Birth ◽  
The Impact

Objectives. To examine the differences in adolescent birth rates by deprivation and Health Professional Shortage Areas (HPSAs) in rural and urban counties of the United States in 2017 and 2018. Methods. We analyzed available data on birth rates for females aged 15 to 19 years in the United States using the restricted-use natality files from the National Center for Health Statistics, American Community Survey 5-year population estimates, and the Area Health Resources Files. Results. Rural counties had an additional 7.8 births per 1000 females aged 15 to 19 years (b = 7.84; 95% confidence interval [CI] = 7.13, 8.55) compared with urban counties. Counties with the highest deprivation had an additional 23.1 births per 1000 females aged 15 to 19 years (b = 23.12; 95% CI = 22.30, 23.93), compared with less deprived counties. Rural counties with whole shortage designation had an additional 8.3 births per 1000 females aged 15 to 19 years (b = 8.27; 95% CI = 6.86, 9.67) compared with their urban counterparts. Conclusions. Rural communities across deprivation and HPSA categories showed disproportionately high adolescent birth rates. Future research should examine the extent to which contraceptive access differs among deprived and HPSA-designated rural communities and the impact of policies that may create barriers for rural communities.

The economic burden of vertigo and dizziness in the United States

2020 ◽  
pp. 1-10
Author(s):  
Jeremy S. Ruthberg ◽  
Chandruganesh Rasendran ◽  
Armine Kocharyan ◽  
Sarah E. Mowry ◽  
Todd D. Otteson
Keyword(s):  
United States ◽  
Health Care ◽  
Economic Burden ◽  
Clinical Characteristics ◽  
Care Service ◽  
Adult Population ◽  
Health Care Service ◽  
The United States ◽  
Medical Expenditures ◽  
Limited Information

BACKGROUND: Vertigo and dizziness are extremely common conditions in the adult population and therefore place a significant social and economic burden on both patients and the healthcare system. However, limited information is available for the economic burden of vertigo and dizziness across various health care settings. OBJECTIVE: Estimate the economic burden of vertigo and dizziness, controlling for demographic, socioeconomic, and clinical comorbidities. METHODS: A retrospective analysis of data from the Medical Expenditures Panel Survey (2007–2015) was performed to analyze individuals with vertigo or dizziness from a nationally representative sample of the United States. Participants were included via self-reported data and International Classification of Diseases, 9th Revision Clinical Modification codes. A cross-validated 2-component generalized linear model was utilized to assess vertigo and dizziness expenditures across demographic, socioeconomic and clinical characteristics while controlling for covariates. Costs and utilization across various health care service sectors, including inpatient, outpatient, emergency department, home health, and prescription medications were evaluated. RESULTS: Of 221,273 patients over 18 years, 5,275 (66% female, 34% male) reported either vertigo or dizziness during 2007–2015. More patients with vertigo or dizziness were female, older, non-Hispanic Caucasian, publicly insured, and had significant clinical comorbidities compared to patients without either condition. Furthermore, each of these demographic, socioeconomic, and clinical characteristics lead to significantly elevated costs due to having these conditions for patients. Significantly higher medical expenditures and utilization across various healthcare sectors were associated with vertigo or dizziness (p <  0.001). The mean incremental annual healthcare expenditure directly associated with vertigo or dizziness was $2,658.73 (95% CI: 1868.79, 3385.66) after controlling for socioeconomic and demographic characteristics. Total annual medical expenditures for patients with dizziness or vertigo was $48.1 billion. CONCLUSION: Vertigo and dizziness lead to substantial expenses for patients across various healthcare settings. Determining how to limit costs and improve the delivery of care for these patients is of the utmost importance given the severe morbidity, disruption to daily living, and major socioeconomic burden associated with these conditions.

scholarly journals Suicide Prevention Training: Policies for Health Care Professionals Across the United States as of October 2017

2018 ◽  
Vol 108 (6) ◽  
pp. 760-768 ◽  
Author(s):  
Janessa M. Graves ◽  
Jessica L. Mackelprang ◽  
Sara E. Van Natta ◽  
Carrie Holliday
Keyword(s):  
United States ◽  
Health Care ◽  
Suicide Prevention ◽  
Health Care Professionals ◽  
The United States ◽  
Prevention Training ◽  
Suicide Prevention Training

scholarly journals Rates and Associated Factors of Secondary Mental Health Care Utilisation among Ex-Military Personnel in the United States: A Narrative Review

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 18 ◽  
Author(s):  
Katharine Mark ◽  
Dominic Murphy ◽  
Sharon Stevelink ◽  
Nicola Fear
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Mental Health Care ◽  
Military Personnel ◽  
Mental Health Problems ◽  
The United States ◽  
Health Care Utilisation ◽  
Narrative Review ◽  
Care Utilisation

Little is known about ex-serving military personnel who access secondary mental health care. This narrative review focuses on studies that quantitatively measure secondary mental health care utilisation in ex-serving personnel from the United States. The review aimed to identify rates of mental health care utilisation, as well as the factors associated with it. The electronic bibliographic databases OVID Medline, PsycInfo, PsycArticles, and Embase were searched for studies published between January 2001 and September 2018. Papers were retained if they included ex-serving personnel, where the majority of the sample had deployed to the recent conflicts in Iraq or Afghanistan. Fifteen studies were included. Modest rates of secondary mental health care utilisation were found in former military members—for mean percentage prevalence rates, values ranged from 12.5% for at least one psychiatric inpatient episode, to 63.2% for at least one outpatient mental health appointment. Individuals engaged in outpatient care visits most often, most likely because these appointments are the most commonly offered source of support. Post-traumatic stress disorder, particularly re-experiencing symptoms, and comorbid mental health problems were most consistently associated with higher mental health care utilisation. Easily accessible interventions aimed at facilitating higher rates of help seeking in ex-serving personnel are recommended.

Immigration and Contract Problems Experienced by Foreign-Educated Nurses

2012 ◽  
Vol 69 (3) ◽  
pp. 351-365 ◽  
Author(s):  
Patricia Pittman ◽  
Carolina Herrera ◽  
Joanne Spetz ◽  
Catherine R. Davis
Keyword(s):  
United States ◽  
Health Care ◽  
Low Income ◽  
The United States ◽  
Low Income Countries ◽  
Labor Rights ◽  
Care Practice ◽  
Quality Health Care ◽  
International Recruitment ◽  
The Impact

More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.

scholarly journals Federal, State, and Local Nutrition Policies for Cancer Prevention: Perceived Impact and Feasibility, United States, 2018

2020 ◽  
Vol 110 (7) ◽  
pp. 1006-1008
Author(s):  
Lauren Lizewski ◽  
Grace Flaherty ◽  
Parke Wilde ◽  
Ross Brownson ◽  
Claire Wang ◽  
...  
Keyword(s):  
United States ◽  
Cancer Prevention ◽  
The United States ◽  
Federal State ◽  
Future Research ◽  
Assistance Program ◽  
Nutrition Policies ◽  
Perceived Impact ◽  
State And Local ◽  
The Impact

Objectives. To assess stakeholder perceptions of the impact and feasibility of 21 national, state, and local nutrition policies for cancer prevention across 5 domains in the United States. Methods. We conducted an online survey from October through December 2018. Participants were invited to take the survey via direct e-mail contact or an organizational e-newsletter. Results. Federal or state Medicare/Medicaid coverage of nutrition counseling and federal or state subsidies on fruits, vegetables, and whole grains for participants in the Supplemental Nutrition Assistance Program were the policies rated as having the highest perceived impact and feasibility. Overall, the 170 respondents rated policy impact higher than policy feasibility. Polices at the federal or state level had a higher perceived impact, whereas local policies had higher perceived feasibility. Conclusions. Our findings might guide future research and advocacy that can ultimately motivate and target policy actions to reduce cancer burdens and disparities in the United States.

Videoconferencing and Dietitian Services: In Rural Ontario Communities

2012 ◽  
Vol 73 (4) ◽  
pp. 176-180
Author(s):  
Diana Stenlund
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Services ◽  
Future Research ◽  
Short Supply ◽  
Care Services ◽  
Alternative Approach ◽  
Access To Health

Registered dietitians (RDs) are regulated health professionals in short supply in Ontario and throughout Canada. Projected workforce studies indicate the situation will likely worsen. Accessing these nutrition specialists is an even greater concern for residents living in rural or remote regions of the province. Smaller communities are increasingly using telehealth as a way to deliver health care services and to improve access to health care professionals. The adoption of interactive videoconferencing as a telehealth application is examined as an alternative approach for accessing RDs in rural communities. While valid reasons exist for implementing videoconferencing, other issues must be considered. These include costs, technological requirements, organizational readiness, and legal and ethical concerns. Future research must fully address the concept of videoconferencing in relation to the Canadian dietetic workforce and practice requirements.

The future of Indian Health Services for native Americans in the United States: an analysis of policy options and recommendations

2016 ◽  
Vol 11 (4) ◽  
pp. 397-414
Author(s):  
Tiffany Henley ◽  
Maureen Boshier
Keyword(s):  
United States ◽  
Health Care ◽  
Native Americans ◽  
American Indians ◽  
Health Care Services ◽  
The United States ◽  
Policy Options ◽  
Care Services ◽  
Policy Window ◽  
The Impact

AbstractThe passage of the Affordable Care Act in the United States has opened a policy window for the establishment of an independent Medicaid agency for the Navajo Nation. This article explores several policy options to improve health care services for Native Americans. Although there is a lack of scholarly research on the impact of healthcare reform and the effectiveness of current health care programs for American Indians, policymakers should utilize evidence-based research to inform policy decisions.

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