Maine Rural Health Research Center

Maine Rural Health Profiles: A Statewide View of Rural Health

Abstract: 

In an effort to inform and promote local discussions and strategic planning for transforming health and health care in rural communities, the Maine Health Access Foundation commissioned the Maine Rural Health Research Center to conduct a study of Maine’s health resources and health status. The result of this study, Maine Rural Health Profiles, presents a summary look at the health status of the state and each of the 16 Maine counties' health system, health system resources (such as workforce and facilities for health services provision), health care economy, and access to care.

Maine Rural Health Profiles uses a combination of narrative and maps to discuss and illustrate both the degree of rurality in each county and how the data reported reflect rural health challenges and opportunities. Many indicators at the county level, such as per capita hospital bed counts and per capita supply of various health professionals, are compared to the state as a whole. By design, the profiles focus on health care delivery sites, with special attention to hospital-based resources, and long-term services and supports. The profiles were developed using secondary data—combining federal and state licensure and provider information with resources such as the Maine Shared Health Needs Assessment & Planning Process (SHNAPP) Project reports and the University of Wisconsin Population Health Institute and Robert Wood Johnson Foundation’s County Health Rankings.

 

Suggested citation:

Kahn-Troster S, Burgess A, Coburn A, et al. Maine Rural Health Profiles. Portland, ME: University of Southern Maine, Muskie School, Maine Rural Health Research Center; September, 2016.

Publication Type: 
Report
Publish Date: 
September 26, 2016
URL: 
http://www.mehaf.org/learning-resources/reports-research/

Developing Program Performance Measures for Rural Emergency Medical Services

Abstract: 

 Prehospital Emergency Care

Developing Program Performance Measures for Rural Emergency Medical Services

Authors: John Gale, MS; Andrew Coburn, PhD; Karen Pearson, MLIS, MA; Zach Croll, BA; George Shaler, MPH

University of Southern Maine, Muskie School of Public Service

Background: The development of measures to monitor and evaluate the performance and quality of emergency medical services (EMS) systems has been a focus of attention for many years. The Medicare Rural Hospital Flexibility Program (Flex Program), established by Congress in 1997, provides grants to states to implement initiatives to strengthen rural healthcare delivery systems, including better integration of EMS into those systems of care.

Objective: Building on national efforts to develop EMS performance measures, we sought to identify measures relevant to the rural communities and hospitals supported by the Flex Program. The measures are intended for use in monitoring rural EMS performance at the community level as well as for use by State Flex Programs and the Federal Office of Rural Health Policy (FORHP) to demonstrate the impact of the Flex Program.

Methods: To evaluate the performance of EMS in rural communities, we conducted a literature search, reviewed research on performance measures conducted by key EMS organizations, and recruited a panel of EMS experts to identify and rate rurally-relevant EMS performance measures as well as emergent protocols for episodes of trauma, ST Elevation Myocardial Infarction (STEMI), and stroke. The rated measures were assessed for inclusion in the final measure set.

Results: The Expert Panel identified 17 program performance measures to support EMS services in rural communities. These measures monitor the capacity of local agencies to collect and report quality and financial data, use the data to improve agency performance, and train rural EMS employees in emergent protocols for all age groups.

Conclusion: The system of care approach on which this rural EMS measures set is based can support the FORHP's goal of better focusing State Flex Program activity to improve program impact on the performance of rural EMS services in the areas of financial viability, quality improvement, and local/regional health system performance. [Journal abstract provided by authors]

Suggested citation:

Gale, J., Coburn, A., Pearson, K., Croll, Z., & Shaler, G. (2016). Developing program performance measures for rural emergency medical services. Prehospital Emergency Care, 1-9. doi: 10.1080/10903127.2016.1218978

FMI: John Gale

Publication Type: 
Journal Article
Publish Date: 
September 9, 2016
URL: 
http://dx.doi.org/10.1080/10903127.2016.1218978

Mental Health First Aid in Rural Communities

Abstract: 

Mental Health First Aid (MHFA), an early intervention training program for general audiences, has been promoted as a means for improving population-level behavioral health (BH) in rural communities by encouraging treatment-seeking. This study, conducted by researchers at the Maine Rural Health Research Center, examined MHFA's appropriateness and impacts in rural contexts. 

Findings: MHFA appears aligned with some key rural needs. MHFA may help to reduce unmet need for BH treatment in rural communities by raising awareness of BH issues and mitigating stigma, thereby promoting appropriate treatment-seeking. However, rural infrastructure deficits may limit some communities’ ability to meet new demand generated by MHFA. MHFA may help motivate rural communities to develop initiatives for strengthening infrastructure, but additional tools and consultation may be needed.

Conclusions: This study provides preliminary evidence that MHFA holds promise for improving rural BH. MHFA alone cannot compensate for weaknesses in rural BH infrastructure.

Article first published online: January 28, 2016

Suggested Citation: Talbot, J. A., Ziller, E. C. and Szlosek, D. A. (2016), Mental Health First Aid in Rural Communities: Appropriateness and Outcomes. The Journal of Rural Health. doi: 10.1111/jrh.12173

Publication Type: 
Journal Article
Publish Date: 
January 28, 2016
URL: 
http://onlinelibrary.wiley.com/doi/10.1111/jrh.12173/abstract?campaign=wolearlyview

Understanding the Business Case for Telemental Health in Rural Communities

Abstract: 

Telemental health has been promoted to address long-standing access barriers to rural mental health care, including low supply and long travel distances. Examples of rural telemental health programs are common; there is a less clear picture of how widely implemented these programs are, their organization, staffing, and services. There is also a need to understand the business case for these programs and assess whether and how they might realize their promise. To address these gaps, a national study was conducted of rural telemental health programs including an online survey of 53 programs and follow-up interviews with 23 programs. This article describes the current landscape and characteristics of these programs and then examines their business case. Can rural telemental health programs be sustained within current delivery systems and reimbursement structures? This question is explored in four areas: need and demand, infrastructure and workforce, funding and reimbursement, and organizational fit and alignment. [Journal Abstract]

Suggested Citation: Lambert, D., Gale, J., Hartley, D., Croll, Z., & Hansen, A. (2015). Understanding the business case for telemental health in rural communities. Journal of Behavioral Health Services and Research. doi: 10.1007/s11414-015-9490-7 [epub ahead of print].

FMI: John Gale

Publication Type: 
Journal Article
Publish Date: 
December 22, 2015

Exploring the Business Case for Children's Telebehavioral Health

Abstract: 

This brief, authored by John Gale, M.S. and David Lambert, Ph.D. from the University of Southern Maine's Muskie School of Public Service, Maine Rural Health Research Center, explores terminology, reimbursement and business issues, and provides examples from the field in the development of telebehavioral health services. In the first section, the authors place children’s telebehavioral health within the context and demands of today’s rural healthcare system, where the majority of children’s telebehavioral health services are delivered. They then describe three examples of the use of telebehavioral health to serve children, adolescents, and families in rural communities. The brief concludes by exploring the business case for telebehavioral health including the issues and challenges of service delivery, coordination, and financing. This brief is informed by a national study of telemental health (serving children, adults, and older persons) in rural health systems conducted by the authors and updated to reflect the latest information on three case examples.

For more information, please contact John Gale at john.gale@maine.edu

Suggested citation: Gale J, Lambert D. Exploring the Business Case for Children's Telebehavioral Health. Washington, DC: The Technical Assistance Network for Children's Behavioral Health, The Institute for Innovation & Implementation; March, 2015. Brief.

Publication Type: 
Research and Policy Brief
Publish Date: 
March 2, 2015

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