Defining "rural" for veterans' health care planning.

Purpose: The Veterans Health Administration (VHA) devised an algorithm to classify veterans as Urban, Rural, or Highly Rural residents. To understand the policy implications of the VHA scheme, we compared its categories to 3 Office of Management and Budget (OMB) and 4 Rural-Urban Commuting Area (RUCA) geographical categories.

Method: Using residence information for VHA health care enrollees, we compared urban-rural classifications under the VHA, OMB, and RUCA schemes; the distributions of rural enrollees across VHA health care networks (Veterans Integrated Service Networks [VISNs]); and how each scheme indicates whether VHA standards for travel time to care are met for the most rural veterans.

Inpatient hospital service utilization of the uninsured in Nebraska: policy implications for addressing uncompensated care.

In order better to inform policymakers about financing uncompensated hospital care through appropriate allocation of resources among Nebraska communities, this study used seven years (1996-2002) of county-level data from multiple sources to examine the relationship between population economic factors and the hospital inpatient care use by uninsured patients. The generalized estimating equation (GEE) regression analysis showed that, at the county level, the population uninsurance rate and other economic factors (e.g.

Reliance on independently owned pharmacies in rural America.

The purpose of this policy brief is to provide researchers, policy makers, and stakeholders with the locations of independently owned pharmacies in rural America that are the sole sources of access to local pharmaceutical services. Organizations representing those pharmacies have argued that the advent of Medicare prescription drug plans threatens the financial viability of those pharmacies (Grisnik 2006). In addition, some pharmacists have expressed concerns about changes in Medicaid reimbursement for pharmaceuticals brought about by the Deficit Reduction Act (DRA) of 2005.

A method for identifying places in rural America at risk of not being able to support adequate health services.

Context: Public policymakers and their advisers struggle with the problem of specifying criteria by which health care providers in rural areas are eligible for special consideration in payment policies and for special grant programs. A means of designating places can provide a basis for assistance and can help target public resources for any providers who deliver services in those places.

Purpose: This paper provides the details underlying a place-based approach to identifying rural areas that are at risk for not being able to provide requisite health services.