Thomas C Ricketts
Dados Biográficos
| ID | 1488204 |
|---|---|
| NOME | Thomas C Ricketts |
| PRENOMES | Thomas C |
| SOBRENOME | Ricketts |
| ASSINATURA | RICKETTS T C |
| AFILIAÇÕES | University of North Carolina at Chapel Hill |
| ORCID | 0000-0002-5262-4849 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 48 |
| TOTAL DE CITAÇÕES | 83 |
| TOTAL COMO AUTOR | 48 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1983 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2018 |
| ÍNDICE H | 4 |
Integrating Qualitative and Quantitative Data in the Development of Outcome Measures
While it is important to treat symptoms, there is growing recognition that in order to help people with mental health problems lead meaningful and fulfilling lives, it is crucial to capture the impact of their conditions on wider aspects of their social lives. We constructed two versions of the Recovering Quality of Life (ReQoL) measure—ReQoL-10 and ReQoL-20—for use in routine settings and clinical trials from a larger pool of items by combining …
The importance of content and face validity in instrument development
This research has underlined the importance of service users' views on the acceptability and validity of items for use in developing a new measure. Whether or not service users favoured an item was associated with their ability or intention to respond accurately and honestly to the item which will impact on the validity and sensitivity of the measure
Developing a Research Agenda for Cardiovascular Disease Prevention in High-Risk Rural Communities
The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportion…
The Association of Changes in Local Health Department Resources With Changes in State-Level Health Outcomes
We explored the association between changes in local health department (LHD) resource levels with changes in health outcomes via a retrospective cohort study. We measured changes in expenditures and staffing reported by LHDs on the 1997 and 2005 National Association of County and City Health Officials surveys and assessed changes in state-level health outcomes with the America's Health Rankings reports for those years. We used pairwise correlatio…
The road to efficiency? Re-examining the impact of the primary care physician workforce on health care utilization rates
Organisation territoriale de l'offre de soins primaires destinée aux populations les plus défavorisées, l'exemple de l'État de Caroline du Nord
Avec la loi sur les assurances maladie, qui a pris effet au 1er janvier 2006, les Pays-Bas ont mis en place un système d’assurances maladie privatisé mais fortement encadré. S’il n’est pas encore possible de mesurer les effets de cette réforme sur la maîtrise des dépenses de santé, on peut, à partir d’une analyse secondaire de premiers travaux néerlandais disponibles, tenter un premier bilan de cette nouvelle assurance-maladie. En termes d’univer…
Urban‐Rural Flows of Physicians
Context: Physician supply is anticipated to fall short of national requirements over the next 20 years. Rural areas are likely to lose relatively more physicians. Policy makers must know how to anticipate what changes in distribution are likely to happen to better target policies. Purpose: To determine whether there was a significant flow of physicians from urban to rural areas in recent years when the overall supply of physicians has been consid…
Defining Urban and Rural Areas in U.S. Epidemiologic Studies
Workforce Issues in Rural Areas
Rural communities in the United States are served by relatively fewer health care professionals than urban or suburban areas. I review the geographic distribution of 6 classes of health professionals and describe the multiple government and private policies and programs intended to affect their geographic distribution. These programs can be classified into 3 categories—coercive, normative, and utilitarian—that characterize the major policy levers…
Aids and "shared sovereignty" in Tanzania from 1987 to 2000
Arguing for Rural Health in Medicare
Rural health policy is the laws, regulations, rules, and interpretations that benefit or affect health and health care for rural populations. This paper examines how rural health policy is viewed in the broader field of public policy, discusses the role of advocacy in developing rural health policy, and suggests ways to make that advocacy more effective. This paper critically reviews policy statements and policy positions taken by key opinion lea…
The Changing Metropolitan Designation Process and Rural America
In June 2003, the Office of Management and Budget (OMB) released new county‐based designations of Core Based Statistical Areas (CBSAs), replacing Metropolitan Statistical Area designations that were last revised in 1990. In this article, the new designations are briefly described, and counties that have changed classifications are identified. The new designations identify 2 categories of counties or county clusters within CBSAs: Metropolitan Stat…
An Analysis of Medicare's Incentive Payment Program for Physicians in Health Professional Shortage Areas
Context: Medicare's Incentive Payment (MIP) program provides a 10% bonus payment to providers who treat Medicare patients in rural and urban areas where there is a shortage of generalist physicians. Purpose: To examine the experience of Alaska, Idaho, North Carolina, South Carolina, and Washington with the MIP program. We determined the program's utilization and which types of physicians received payments. Methods: Retrospective cohort design, ut…
Use of Program Logic Models in the Southern Rural Access Program Evaluation
The Southern Rural Access Program (SRAP) evaluation team used program logic models to clarify grantees' activities, objectives, and timelines. This information was used to benchmark data from grantees' progress reports to assess the program's successes. This article presents a brief background on the use of program logic models‐essentially charts or diagrams specifying a program's planned activities, objectives, and goals–for evaluating and manag…
Rural Health Research and Rural Health in the 21st Century
Rural health research is a unique field. It is neither a nested subcategory under general health services research nor a separate field of policy analysis or advocacy. Rural health research faces three potential crises: of content, of applicability, and of credibility. The content of the field is driven often by funds, its applicability is thus limited by its purview as well as its special constituency, and its credibility is challenged by its fi…
Hospitalization rates as indicators of access to primary care
The Content of Rural Health Research
How Many Rural Doctors Do We Have
The number of physicians practicing in the nonmetropolitan areas of the United States in relation to population has increased over the past two decades, but more slowly than the number of physicians in metropolitan counties. During the same period, there was a growing acceptance of the perception that the physician workforce in the United States exceeded the number necessary to meet the requirements of an efficient health care system. This has ca…
Rural Health History
The Role of Physician Recommendation in Women's Mammography Use
A 2-stage model for estimating mammography use among women with regular physicians may be more informative than a single model. These results imply that programs designed to increase mammography rates should focus on ensuring appropriate physician recommendations in addition to encouraging women to request screening. Future research should consider using an integrated framework for evaluating utilization of mammography and other preventive servic…
Proposed Changes to Designations of Medically Underserved Populations and Health Professional Shortage Areas
This paper reports an analysis of the proposed rule to combine medically under‐served population (MUP) and health professional shortage area (HPSA) designations, as published by the Bureau of Primay Health Care (BPHC) in the Federal Register on Sept. 1, 1998 (Department of Health and Human Services, 1998). The efects of the proposed rule overall and on rural communities were examined, particularly with respect to current whole county HPSA designa…
Economic Impact of Hospital Closure on Small Rural Counties, 1984 to 1988
Hospital closure in a rural community may affect the locale's economic prospects as well as the health of its residents. Studies of economic effects have primarily relied on modeling techniques rather than observation of actual change. This study demonstrates the use of a comparative analysis approach for estimating the economic effects of hospital closure on small rural counties. The experiences of 203 small rural counties at which a hospital cl…
Preparing Rural Communities for Managed Care
Policies for Rural Health Care
The Medicare Critical Access Hospital Program
The Medicare Critical Access Hospital (CAH) program, part of the Balanced Budget Act of 1997, is a nationwide limited service hospital program. Structured interviews were conducted in August and September 1998 with key people in state offices of rural health, state hospital associations, departments of health or departments of facility licensing in all 50 states to assess their progress in the development of the CAH program. The majority of state…
Defining Urban and Rural Areas in U.S. Epidemiologic Studies
Hospitalization rates as indicators of access to primary care
The Association of Changes in Local Health Department Resources With Changes in State-Level Health Outcomes
We explored the association between changes in local health department (LHD) resource levels with changes in health outcomes via a retrospective cohort study. We measured changes in expenditures and staffing reported by LHDs on the 1997 and 2005 National Association of County and City Health Officials surveys and assessed changes in state-level health outcomes with the America's Health Rankings reports for those years. We used pairwise correlatio…
The road to efficiency? Re-examining the impact of the primary care physician workforce on health care utilization rates
An evaluation of subsidized rural primary care programs
The placement of subsidized primary care programs in rural communities has been an important aspect of national health policy over the last decade. Using survey and secondary data from programs in over 700 counties in the United States, it was found that while about one-fourth of all counties with some rural populations have been affected by these programs, certain environmental factors are associated with more or less likelihood of placement. Hi…
An evaluation of subsidized rural primary care programs
The design of a comprehensive evaluation of subsidized rural primary care programs on a large national scale is described, Its major purpose is to derive data whose analysis will answer major policy questions about the factors influencing the outcome of the major types of such programs in different communities. This first paper also delineates a typology which was developed of five principal organizational forms of these programs. This classifica…
Workforce Issues in Rural Areas
Rural communities in the United States are served by relatively fewer health care professionals than urban or suburban areas. I review the geographic distribution of 6 classes of health professionals and describe the multiple government and private policies and programs intended to affect their geographic distribution. These programs can be classified into 3 categories—coercive, normative, and utilitarian—that characterize the major policy levers…
An evaluation of subsidized rural primary care programs
Surveys of a national sample of 193 subsidized rural primary care programs were conducted in 1981 and 1982 to determine what adaptations the programs might anticipate making given a reduction in their subsidy and what actual changes they made after the implementation of new federal policies and in the face of severe economic recession. During the period between the two surveys, nine of the 193 programs closed. The remaining programs changed eleme…
Developing a Research Agenda for Cardiovascular Disease Prevention in High-Risk Rural Communities
The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportion…
Aids and "shared sovereignty" in Tanzania from 1987 to 2000
An evaluation of subsidized rural primary care programs
Subsidized rural clinics and providers have long depended on the rural hospital for the care of some of their patients; the hospital has also been a source of revenue for these providers and programs. We studied a representative national sample of 116 subsidized rural clinics, focusing on the impact on rural clinic costs and revenues of the use of the hospital by the clinics' providers. Both clinic costs and revenue are reduced by the use of the …
An evaluation of subsidized rural primary care programs
The placement of subsidized primary care programs in rural communities has been an important aspect of national health policy over the last decade. Using survey and secondary data from programs in over 700 counties in the United States, it was found that while about one-fourth of all counties with some rural populations have been affected by these programs, certain environmental factors are associated with more or less likelihood of placement. Hi…
An evaluation of subsidized rural primary care programs
The design of a comprehensive evaluation of subsidized rural primary care programs on a large national scale is described, Its major purpose is to derive data whose analysis will answer major policy questions about the factors influencing the outcome of the major types of such programs in different communities. This first paper also delineates a typology which was developed of five principal organizational forms of these programs. This classifica…
An evaluation of subsidized rural primary care programs
Surveys of a national sample of 193 subsidized rural primary care programs were conducted in 1981 and 1982 to determine what adaptations the programs might anticipate making given a reduction in their subsidy and what actual changes they made after the implementation of new federal policies and in the face of severe economic recession. During the period between the two surveys, nine of the 193 programs closed. The remaining programs changed eleme…
The Ability of Aggregate Data to Predict Self‐Sufficiency Levels in Subsidized Rural Primary Care Practices
American rural health policy has as its long‐term goal the reallocation of health facilities and manpower to permit equitable access to primary care for all citizens. Rural health centers subsidized by governmental and philanthropic programs frequently have been placed in places of high need for their services. Yet both government and philanthropic policymakers expect these primary care practices to become economically self‐sufficient within a fe…
An evaluation of subsidized rural primary care programs
Subsidized rural clinics and providers have long depended on the rural hospital for the care of some of their patients; the hospital has also been a source of revenue for these providers and programs. We studied a representative national sample of 116 subsidized rural clinics, focusing on the impact on rural clinic costs and revenues of the use of the hospital by the clinics' providers. Both clinic costs and revenue are reduced by the use of the …
Cancer prevention in the workplace
The implementation of cancer prevention programmes in the workplace presents a significant opportunity to reduce occupational cancers. Unfortunately, implementation is not only hampered by problems of conceptualization, measurement and approach, but also by the organizational context within which the programme is implemented. To overcome these barriers, cancer prevention may be defined as an organizational innovation and in so doing attention giv…
Innovation within innovation
1Director, Rural Health Research Program Health Services Research Center 2Department of Health Policy and Administration School of Public Health University of North Carolina at Chapel Hill Chapel Hill, North Carolina
Competition and Rural Primary Care Programs
Rural primary care programs were established in areas where there was thought to be no competition for patients. However, evidence from site visits and surveys of a national sample of subsidized programs revealed a pattern of competitive responses by the clinics. In this study of 193 rural primary care programs, mail and telephone surveys produced uniform data on the organization, operation, finances, and utilization of a representative sample of…
Education of Physician Assistants, Nurse Midwives, and Nurse Practitioners for Rural Practice
Physician assistants, nurse midwives, and nurse practitioners have been described as a vital and unique solution to the problem of providing adequate access to high quality health care for many Americans. Each of these classifications of health care providers has been accepted as separate professions with their own standards and identities. Their curricula and educational pathways have developed into clearly distinguishable educational tracks tha…
Determining Adequacy of Physicians and Nurses for Rural Populations
Cancer in Rural Versus Urban Populations
Rural‐urban comparisons have identified higher age‐, race‐, and sex‐adjusted cancer incidence and mortality rates in urban populations for most anatomic sites, suggesting that rural populations are at lower risk from cancer. Conversely, findings that rural cancer patients are diagnosed at later stages of disease, that higher proportions of rural cancer cases are unstaged at diagnosis, and that rural cancer patients are at a more advanced stage of…
The North Carolina Obstetrics Access and Professional Liability Study
During the 1980s a rapid rise in the costs of malpractice coverage for obstetrical services caused many practitioners to stop delivering babies. Other factors also influenced the decision by physicians to exclude obstetrics from their practices, including: increases in malpractice claims made against obstetrical providers and the subsequent fear of being sued; closures of hospital obstetrics units; issues involving Medicaid; and the daily stresse…
The Determinants of Utilization of Nonphysician Providers in Rural Community and Migrant Health Centers
The use of nonphysician providers, such as nurse practitioners, physician assistants, and certified nurse midwives, in rural areas is critically important due to the continued primary care access problems. This study examines the major factors influencing the use of nonphysician providers in rural community and migrant health centers based on a 1991 national survey of the centers. This study demonstrates that the employment of nonphysician provid…
Health in Rural North America
Experts in public health, geography, and demography examine the spatial aspects of rural health care services and delivery. They pay special attention to high-risk populations children, the elderly, disabled people, the mentally ill and make policy suggestions. Annotation copyright Book News, Inc. P
Patterns of Obstetrical Care in Single-Hospital, Rural Counties
This study used logistic regression to identify differences in community-level characteristics of small, rural hospitals that provided obstetrical services compared to those that did not. The hypothesis was that community characteristics, such as demographics, geographic location, and socioeconomic status influence the ability of rural hospitals to sustain obstetrical services locally. The sample included small (fewer than 100 beds) non-federal, …
Preliminary Evidence on Retention Rates of Primary Care Physicians in Rural and Urban Areas
The primary study objectives were to 1) determine how many physicians entered primary care practice in rural and urban counties of North Carolina in the 1981 to 1989 period and 2) estimate their length of tenure in these areas. The secondary objective was to identify the physician's demographic, training, and practice characteristics that influence geographic location of practice and length of tenure. A cohort of 1,947 physicians was identified f…
Networks and Rural Health
Using Logistic Regression to make County‐level Estimates of the Medically Uninsured in North Carolina
Often, policy analysts are asked to produce data for which there are no universally accepted methods. Policymakers and legislators are continually searching for accurate estimates of the magnitude of the problem with which to inform their debate, but often need the estimates within a short period of time—too short to allow large, population‐based sample surveys. This means that such estimates must be produced from data that may lack the specifici…
The Effects of Having a Regular Doctor on Access to Primary Care
The authors assessed the relationship between having a regular doctor and access to care, as measured by a set of preventive and primary care utilization indicators recommended by the Institute of Medicine. The 1987 National Medical Expenditure Survey was used in the analyses (n = 30,012). The results of the regression analyses suggest that individuals with any type of regular source of care had better access than those without a regular source o…
Migration of Obstetrician-Gynecologists Into and Out of Rural Areas, 1985 to 1990
This study sought to determine if county-level demographic, health care resource, policy, and competitive factors are associated with the movement of obstetrician-gynecologists (ob-gyns) into and out of rural areas. County-level descriptive data from the Area Resource File, the American Medical Association Physician Masterfile, and the American Hospital Association Guide were used for hospital descriptions. This was a correlational study that mea…
Access and Ambulatory Care Sensitive Conditions
The Effects of Community and Migrant Health Centers on Rural Communities
Do International Medical Graduates Reduce Rural Physician Shortages
OBJECTIVES: The authors examined whether international medical graduates (IMGs) constitute a greater percentage of the US physician workforce in rural underserved areas than in rural non-underserved areas. Research findings could help policymakers determine whether the role of international medical graduates in compensating for local physician shortages counterbalances international medical graduates' potential for exacerbating a national oversup…
Proposed Changes to Designations of Medically Underserved Populations and Health Professional Shortage Areas
This paper reports an analysis of the proposed rule to combine medically under‐served population (MUP) and health professional shortage area (HPSA) designations, as published by the Bureau of Primay Health Care (BPHC) in the Federal Register on Sept. 1, 1998 (Department of Health and Human Services, 1998). The efects of the proposed rule overall and on rural communities were examined, particularly with respect to current whole county HPSA designa…
Economic Impact of Hospital Closure on Small Rural Counties, 1984 to 1988
Hospital closure in a rural community may affect the locale's economic prospects as well as the health of its residents. Studies of economic effects have primarily relied on modeling techniques rather than observation of actual change. This study demonstrates the use of a comparative analysis approach for estimating the economic effects of hospital closure on small rural counties. The experiences of 203 small rural counties at which a hospital cl…
Medicine (29 obras) · Global Health Workforce Issues (24 obras) · Healthcare Policy and Management (21 obras) · Economics (20 obras) · Economic growth (18 obras) · Health care (18 obras) · Business (17 obras) · Primary Care and Health Outcomes (17 obras) · Family medicine (16 obras) · Rural area (15 obras)