TEXAS JOURNAL OF RURAL HEALTH

PREVIOUS

ISSUE 21(1), 2003

TABLE OF CONTENTS
 
Editor’s Comments
James E. Rohrer, Ph.D.
FULL TEXT

Notes From the Field

Nursing Shortages in Rural Texas
Elizabeth Ann Roberts
Texas Journal of Rural Health 2003; 21(1): 3-10
ABSTRACT
Emergency Shortages in Rural Texas: A Need for Change
Kristen Robinson
Texas Journal of Rural Health 2003; 21(1): 11-15
ABSTRACT

Policy and Law

Physician Supply: An Economic and Policy Perspective
Peter Hilsenrath, Ph.D., Kristine Lykens, Ph.D., Doug Mains, Dr.PH.
Texas Journal of Rural Health 2003; 21(1): 16-29
ABSTRACT

Research

Predictors of Women's Use of Screening Services
Pamela R. Fritz, M.S.
Texas Journal of Rural Health 2003; 21(1): 30-41
ABSTRACT
Traumatic Brain Injury: Caseload of a Rural Community Brain Injury Service
B. R. Coetzer, D Clin Psy, H. C. Blackwell, MSc.
Texas Journal of Rural Health 2003; 21(1): 42-46
ABSTRACT
The Health Status of Hispanic Migrant Framworkers in Idaho
Ann S. Hunter, Ph.D., Teri R. Hall, Ph.D., Gesine K. Hearn, M.A., Elizabeth Cartwright, Ph.D.
Texas Journal of Rural Health 2003; 21(1): 50-59
ABSTRACT
Utilization of Health Services by Seniors in West Texas
James E. Rohrer, Ph.D., Gina Kruse, M.S., Tyrone Borders, Ph.D., Ke T. Xu, Ph.D., Joel Kupersmith, M.D.
Texas Journal of Rural Health 2003; 21(1): 60-72
ABSTRACT

Special Report

Estimating the Economic Viability of a Hemodialysis Facility
Mary K. Lawler, RN, Ph.D., Gerald A. Doeksen, Ph.D.
Texas Journal of Rural Health 2003; 21(1): 73-81
ABSTRACT

ABSTRACTS

Nursing Shortages in Rural Texas
Elizabeth Ann Roberts
Texas Journal of Rural Health 2003; 21(1): 3-10

Abstract

There is currently a nursing shortage in the state of Texas. Vacancy rates of 9% or above are thought to indicate a significant shortage, and Texas surpasses that rate (Texas Nurses Association, 2000). The supply is shrinking steadily due to a number of factors. Historical facts, the present situation, and different needs in regard to caring for rural populations must be taken into consideration when targeting solutions for the shortage.

Key words: American Hospital Preservation Act, health care eduction, nursing shortage, rural Texas (Texas Journal of Rural Health 2003; 21(1): 3-10)

Author Affiliations

  • Elizabeth Ann Roberts, Community Health Student, Texas A&M University, Pasadena, Texas

Emergency Shortages in Rural Texas: A Need for Change
Kristen Robinson
Texas Journal of Rural Health 2003; 21(1): 11-15

Abstract

In rural areas of Texas, emergency medical care has encountered numerous obstacles that put its future in jeopardy. People depend on the lifesaving skills of the highly trained medical personnel who respond to emergencies, which makes emergency care an integral part of every community. After a review of such issues as untimely transportation, paramedic retention, and declining reimbursement, it is evident that something must be done soon to ensure the survival of these services.

Key words: emergency care, EMS, rural Texas (Texas Journal of Rural Health 2003; 21(1): 11-15)

Author Affiliations

  • Kristen Robinson, Community Health Student, Texas A&M University, College Station, Texas

Physician Supply: An Economic and Policy Perspective
Peter Hilsenrath, Ph.D., Kristine Lykens, Ph.D., Doug Mains, Dr.PH.
Texas Journal of Rural Health 2003; 21(1): 16-29

Abstract

The number of graduates of United States allopathic medical schools has been relatively constant for two decades while national health care utilization and expenditures have risen rapidly. Growing demand for medical residents has largely been met with international medical graduates (IMGs). Physician groups have been concerned about the specter of a surplus of doctors driven by managed care pressures. Deans of allopathic medical schools have been reluctant to increase the supply of United States medical graduates; this is partly due to the lack of economic incentives to admit more students. Consistent with criticism made by Princeton economist Uwe Reinhardt and physician Fitzhugh Mullan, it is argued here that increased numbers of physicians can lead to improved access for lower income groups and rural areas.

Key words: health economics, international medical graduates, physician supply, rural health (Texas Journal of Rural Health 2003; 21(1): 16-29)

Author Affiliations

  • Peter Hilsenrath, Ph.D., Professor, Department of Health Management and Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas
  • Kristine Lykens, Ph.D., Assistant Professor, Department of Health Management and Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas
  • Doug Mains, Dr.PH., Assistant Professor, Department of Health Management and Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas

Predictors of Women's Use of Screening Services
Pamela R. Fritz, M.S.
Texas Journal of Rural Health 2003; 21(1): 30-41

Abstract

The intent of this article is to determine which women have the greatest risk of not obtaining routine cancer screening services such as mammograms, pap smears, and clinical breast examinations and also reviews if living in a rural area effects the receipt of those services.

Key words: cancer screening, health predictors, mammograms, rural health (Texas Journal of Rural Health 2003; 21(1): 30-41)

Author Affiliations

  • Pamela R. Fritz, M.S., Research Aide, Department of Health Services Research and Management, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas

Traumatic Brain Injury: Caseload of a Rural Community Brain Injury Service
B. R. Coetzer, D Clin Psy, H. C. Blackwell, MSc.
Texas Journal of Rural Health 2003; 21(1): 42-46

Abstract

This study investigated the traumatic brain injury (TBI) caseload of a community brain injury service based in a rural area. The total number of referrals received (N = 534) were reviewed over a four and a half year period. Two hundred and seventy six TBI cases were identified. TBI caseload was compared to national and projected local figures as well as findings from a study that investigated community neurorehabilitation teams' caseload. The main findings were that young males made up a high proportion of cases, less TBI cases were identified than suggested by national figures, and older adults made up a higher than expected percentage of the caseload. These findings may have significant implications for the long-term development plans of community-based brain injury rehabilitation services.

Key words: community-based services, rural health, rural Wales, traumatic brain injury. (Texas Journal of Rural Health; 21(1): 42-46)

Author Affiliations

  • B. R. Coetzer, D Clin Psy, Consultant Neuropsychologist/ Head of Service, North Wales Brain Injury Service, Colwyn Bay Hospital, Colwyn Bay, Conwy, Wales, UNITED KINGDOM [Honorary Lecturer, Clinical Psychology Program, University of Wales, Bangor, Gwynedd, Wales, UNITED KINGDOM]
  • H. C. Blackwell, MSc, Assistant Psychologist, North Wales Brain Injury Service, Colwyn Bay Hospital, Colwyn Bay, Conwy, Wales, UNITED KINGDOM

The Health Status of Hispanic Migrant Framworkers in Idaho
Ann S. Hunter, Ph.D., Teri R. Hall, Ph.D., Gesine K. Hearn, M.A., Elizabeth Cartwright, Ph.D.
Texas Journal of Rural Health 2003; 21(1): 50-59

Abstract

This study describes the health status, useful health services, health service needs, and reasons for not seeing a doctor as reported by 179 Hispanic migrant farmworkers in southeastern Idaho. Subjects for this study comprise a convenience sample that was surveyed by bilingual interviewers in 1998. The survey instruments are modifications of Slesinger's (1992) instruments that measured health status among Hispanic farmworkers from the same Midwest Migrant Stream. The average age of the study group (35 years) is relatively young; therefore, it is surprising that such a large share (61%) reported their health as fair or poor. The researchers speculate that alienation from their culture increases incidences of irritability (56%), nervousness (41%), and depression (34%). Results of this study should be of interest to policymakers and service providers.

Key words: health services, Hispanic immigrants, Idaho, migrant farmworkers, rural health (Texas Journal of Rural Health 2003; 21(1): 50-59)

Author Affiliations

  • Ann S. Hunter, Ph.D., Department of Sociology, Criminal Justice, and Social Work, Idaho State University, Pocatello, Idaho
  • Teri R. Hall, Ph.D., Department of Anthropology, Idaho State University, Pocatello, Idaho
  • Gesine K. Hearn, M.A., Department of Sociology, Criminal Justice, and Social Work, Idaho State University, Pocatello, Idaho
  • Elizabeth Cartwright, Ph.D., Department of Anthropology, Idaho State University, Pocatello, Idaho

Utilization of Health Services by Seniors in West Texas
James E. Rohrer, Ph.D., Gina Kruse, M.S., Tyrone Borders, Ph.D., Ke T. Xu, Ph.D., Joel Kupersmith, M.D.
Texas Journal of Rural Health 2003; 21(1): 60-72

Abstract

The purpose of this project was to analyze the correlates of health care utilization among seniors residing in a sparsely populated region. A cross-sectional survey of over 5000 elderly persons was conducted. The subjects were persons who were 65 years of age and older who resided in 108 counties in western Texas. Personal characteristics significantly associated with higher service use included Hispanic ethnicity, age, household structure, skepticism about medical care, and being highly religious. Residence in a rural county and low income were not significant when other variables were controlled.

Key words: access, health beliefs, medical care utilization, medical skepticism, rural health care. (Texas Journal of Rural Health 2002; 20(4): 60-72)

Author Affiliations

  • James E. Rohrer, Ph.D., Professor and Chair, Department of Health Services Research and Management, TTUHSC, School of Medicine, Lubbock, Texas
  • Gina Kruse, M.S., Research Aide, Department of Health Services Research and Management, TTUHSC, School of Medicine, Lubbock, Texas
  • Tyrone Borders, Ph.D., Assistant Professor, Department of Health Services Research and Management, TTUHSC, School of Medicine, Lubbock, Texas
  • Ke T. Xu, Ph.D., Assistant Professor, Department of Health Services Research and Management, TTUHSC, School of Medicine, Lubbock, Texas
  • Joel Kupersmith, M.D., Past Dean of Medicine, Department of Internal Medicine, TTUHSC, School of Medicine, Lubbock, Texas

Estimating the Economic Viability of a Hemodialysis Facility
Mary K. Lawler, RN, Ph.D., Gerald A. Doeksen, Ph.D.
Texas Journal of Rural Health 2003; 21(1): 73-81

Abstract

This article briefly describes the process decision makers can utilize to determine the economic feasibility of a hemodialysis facility for their community. The article reviews selected national studies regarding costs, utilization, and participant characteristics; describes the process for estimating patient participation and revenue associated with a hemodialysis facility; presents capital and operating costs; demonstrates the methodology for estimating the economic viability of a hemodialysis facility through a case study; and summarizes the results.

Hemodialysis facilities provide medical treatment for end-stage renal disease (ESRD) caused primarily by the chronic diseases of diabetes and/or hypertension (high blood pressure). The number of individuals requiring hemodialysis is increasing as the rate of diabetes and hypertension increases and people are living longer. The increased number of patients requiring hemodialysis has placed an increased demand on urban and rural communities to provide hemodialysis facilities that are within a one-hour drive to the patient's home.

This article describes the process individuals and community leaders can follow in considering the establishment of a hemodialysis facility in their community. The overall goal of this article is to describe a method that can be used to estimate the economic viability of a hemodialysis facility. More specifically, the objectives are to (1) review selected national studies regarding costs, utilization, and participant characteristics; (2) describe the process for estimating patient participation and revenue associated with a hemodialysis facility; (3) present capital and operating costs; (4) demonstrate the methodology for estimating the economic viability of a hemodialysis facility through a case study; and (5) summarize results. For additional information see the Guidebook for Estimating the Economic Viability of A Hemodialysis Center (Lawler & Doeksen, 2002).

Key words: economics, hemodialysis, rural health (Texas Journal of Rural Health 2003; 21(1): 73-81)

Author Affiliations

  • Mary K. Lawler, RN, Ph.D., Assistant Extension Specialist, Department of Agricultural Economics, Oklahoma State University, Stillwater, Oklahoma
  • Gerald A. Doeksen, Ph.D., Regents Professor and Extension Economist, Department of Agricultural Economics, Oklahoma State University, Stillwater, Oklahoma
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