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At least 19 recordsLinked to original sources
PubMed1977

Are "medically underserved areas" medically underserved?

A comparison of medically underserved areas (MUAs) and adequately served areas (ASAs) is presented. Nonmetropolitan areas represented in the Health Interview Survey (HIS) are classified as MUAs or ASAs by the official criterion of their scores on the Index of Medical Underservice (IMU), and HIS data from the two types of areas are examined for differences. Standard metropolitan statistical areas are also compared with the nonmetropolitan MUAs and ASAs. Results show no difference between MUA and ASA residents in number of physician visits per year or proportion with at least one visit in the past year, although MUA residents reported poorer health status, used some preventive services less, and used nonsurgical hospitalization more than did ASA residents. In gereral, most MUA-ASA differences tend to be similar in size to differences between ASAs and SMSAs. An alternative to the IMU, using HIS data to identify underserved areas, is discussed.

Adolescent↗
PubMed1998

Federal Employees Health Benefits Program, Medically Underserved Areas for 1999--OPM. Notice of medically underserved areas for 1999.

The Office of Personnel Management has completed its annual calculation of the States that qualify as Medically Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for the calendar year 1999. This is necessary to comply with a provision of FEHB law that mandates special consideration for enrollees of certain FEHB plans who receive covered health services in states with critical shortages of primary care physicians. Accordingly, for calendar year 1999, OPM's calculations show that the following States are Medically Underserved Areas under the FEHB Program: Alabama, Idaho, Louisiana, Mississippi, New Mexico, North Dakota, South Carolina, South Dakota, and Wyoming. West Virginia has been removed from the 1998 list, and Idaho and North Dakota have been added.

Government Agencies↗
PubMed1997

Federal employees health benefits program; medically underserved areas for 1998--OPM. Notice of medically underserved areas for 1998.

The Office of Personnel Management (OPM) has completed its annual calculation of the States that qualify as Medically Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for the calendar year 1998. This is necessary to comply with a provision of FEHB law that mandates special consideration for enrollees of certain FEHB plans who receive covered health services in states with critical shortages of primary care physicians. Accordingly, for calendar year 1998, OPM's calculations show that the following States are Medically Underserved Areas under the FEHB Program: Alabama, Louisiana, Mississippi, New Mexico, South Carolina, South Dakota, West Virginia, and Wyoming. North Dakota has been removed from that list, with no new additions for 1998.

Government Agencies↗
PubMed1991

Federal Employees Health Benefits Program: medically underserved areas for 1992--Office of Personnel Management. Notice of medically underserved areas for 1992.

The Office of Personnel Management has completed its annual determination of the States that qualify as Medically Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 1992. This determination is necessary to comply with a provision of FEHB law that mandates special consideration for enrollees of certain FEHB plans who receive covered health services in States with critical shortages of primary care physicians. Accordingly, for calendar year 1992, OPM has determined that the following States are Medically Underserved Areas under the FEHB Program: Alabama, Idaho, Louisiana, Mississippi, New Mexico, North Dakota, South Dakota, West Virginia, and Wyoming. This list is the same as that for 1991, with the exception of the addition of Alabama.

Government Agencies↗
PubMed1982

Requests that certain areas be designated as medically underserved areas--Health Resources and Services Administration. Notice.

This notice is to advise all interested individuals and organizations particularly Health Systems Agencies and State Health Planning and Development Agencies, that the Department is reviewing a number of requests that certain areas be added to the current listing of areas designated as Medically Underserved Areas (MUAs). Governors of affected States will be consulted by letter regarding the proposed designations in their States. These areas are being reviewed as the result of requests for designation submitted by Health Systems Agencies.

Medically Underserved Area↗
PubMed1981

Designation of medically underserved areas--Health Services Administration. Notice.

This notice is intended to clarify, for purposes of certain Federal health programs, the distinction between designation of an area as a Health Manpower Shortage Area (HMSA) and designation of an area as a Medically Underserved Area (MUA). Although it is possible for an area to be designated as both an HMSA and an MUA, the two designation processes are independent, each having its own established criteria and procedures. An area designated as an HMSA will be considered as an MUA only if it has been formally designated as an MUA under the criteria and procedures published in the Federal Register. The latest such publication is that of October 15, 1976 (41 FR 45718--45777), "Designation of Medically Underserved Areas."

Health Workforce↗
PubMedDate not supplied

The Health Promotion-Disease Prevention Project: effect on medical students' attitudes toward practice in medically underserved areas.

BACKGROUND AND OBJECTIVES: Increasing the supply of primary care physicians who will practice in medically underserved areas is a national concern. This study examined the impact of carefully structured, preclinical, and service-oriented learning experiences in underserved areas on medical student participants' attitudes toward practice in such areas. METHODS: Pre- and post-placement assessments were conducted using a Likert-type scale to measure attitude. Data were obtained from 169 students. A descriptive/interpretational qualitative analysis of participants' final reports of their experiences was conducted to amplify statistical findings. RESULTS: Results indicated an improvement in attitude from pre-placement to post-placement. Also observed were improved perceptions of the competence of physicians, quality of care, and practice environment in underserved areas, along with an improvement in the students' levels of comfort working with underserved patients. CONCLUSIONS: The study findings provide some evidence that supports recommendations for reform of undergraduate medical education to promote primary care specialties and to improve access to health care services for the underserved. These recommendations include early exposure to primary care, opportunities to identify primary care role models, service to the community, introduction to community-oriented primary care skills, and community-based experience.

Attitude of Health Personnel↗
PubMed2002

TRICARE; Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); bonus payments in medically underserved areas. Final rule.

This final rule implements a bonus payment, in addition to the amount normally paid under the allowable charge methodology, to physicians in medically underserved areas. For purposes of this rule, medically underserved areas are the same as those determined by the Secretary of Health and Human Services for the Medicare program. Such bonus payments shall be equal to the bonus payments authorized by Medicare, except as necessary to recognize any unique or distinct characteristics or requirements of the TRICARE program, and as described in instructions issued by the Executive Director, TRICARE Management Activity. This rule promotes a reimbursement enhancement to a limited number of physicians designed to increase TRICARE beneficiary access to care.

Health Benefit Plans, Employee↗
PubMed1982

Designation of medically underserved areas; list of final deletions--Health Resources and Services Administration. Notice.

This notice is to advise all interested individuals and organizations, particularly Health Systems Agencies and State Health Planning and Development Agencies, of the final deletions from the list of areas that have been designated as medically underserved areas (MUAs). The final deletions result from analysis of comments received since the publication on October 28, 1981, in the Federal Register [46 FR 53320] of areas proposed for deletion.

Medically Underserved Area↗
PubMed1996

Is health status related to residence in medically underserved areas? Evidence and implications for policy.

This study sought to compare the health status of adult residents of medically underserved areas (MUAs) with adult residents of nonshortage areas (non-MUAs). A random digit dialing telephone survey was used. Respondents were subsequently classified by their county of residence as residing in an MUA or non-MUA. A sample of 421 adults (aged 18 years or older) residing in Kentucky during 1993 were included in the analysis. Health status was measured by the Medical Outcomes Study 20-item Short-Form Health Survey's (SF-20) six subscales. After controlling in the multiple regression for demographic variables there were no significant differences between residents of MUAs and non-MUAs for the physical functioning, role functioning, general mental health, self-perception of health, or pain subscales. The social functioning subscale was significantly related to the residence in an MUA. The demographic variable "education" was a consistent predictor of each of the health status subscales. Excepting the social functioning subscale, residents of MUAs do not have significant differences in health status when compared to residents of non-MUAs. Future policy may need to focus on other health services shortage area designators that are more highly associated with the health status of residents. Consideration should be given to including the education demographics of areas or populations in health services shortage designation criteria.

Adult↗
PubMed2003

Does exposure to medically underserved areas during training influence eventual choice of practice location?

INTRODUCTION: There are an increasing number of communities within the United States that have limited or no access to primary healthcare. In recognition, many medical schools now provide opportunities and activities that offer exposure to these demographic areas in order to increase the presence of and community access to medical care and to promote these locations as practice site choices for graduating students. Evaluation of these enhancements has led to doubts whether this exposure timing is optimal in promoting practice in these settings. The purpose of this study is to identify whether early exposure(s) to medically underserved settings prior to medical school is associated with eventual choice of practice location. METHODS: Utilising a cross-sectional design, 450 US Family Medicine residency programmes were surveyed. From these, 775 participants responded to a standardised self-administered questionnaire on indicators associated with medically underserved area (MUA) exposure. RESULTS: Early MUA exposures combined with medical training experiences in underserved settings have a positive effect on later practice site choice. Identification of these attributes may be useful in considering determinants that impact eventual choice of practice location.

Humans↗
PubMed2000

Later-stage cancer in relation to medically underserved areas in Connecticut.

Health status indicators, including advanced stage at diagnosis of cancer, have been proposed as indicators of health care access and quality to be considered in revising the definition of medically underserved areas (MUAs). Using the population-based Connecticut Tumor Registry, "outlier" census tracts were defined as those that had a high proportion of breast, colorectal, or cervical cancer diagnosed at later stage, relative to all tracts in the state. In the six Connecticut cities that had MUAs, MUAs comprised the majority of outlier tracts, but non-MUA outliers were often located on the fringes of MUAs. The findings are discussed in relation to revising the criteria for defining MUAs and to targeting interventions for early detection of cancer in urban areas.

Aged↗
PubMed1983

Federal Employees Health Benefits Program; benefits for medically underserved areas--Office of Personnel Management. Final rule.

The Office of Personnel Management (OPM) is amending its regulations pertaining to benefits under the Federal Employees Health Benefits (FEHB) Program for individuals in medically underserved areas, these regulations are necessary to implement the FEHB law, as amended, which mandates special consideration for enrollees of certain FEHB plans who receive covered health service in States with critical shortages of primary care physicians.

Health Benefit Plans, Employee↗
PubMed1982

Federal Employees Health Benefits Program; benefits for medically underserved areas--Office of Personnel Management. Final rule.

The Office of Personnel Management (OPM) is amending its regulations pertaining to benefits under the Federal Employees Health Benefits (FEHB) Program for individuals in medically underserved areas. These regulations are necessary to implement the FEHB law, as amended, which mandates special consideration for enrollees of certain FEHB plans who receive covered health service in States with critical shortages of primary care physicians.

Government↗
PubMedDate not supplied

Factors associated with underimmunization at 3 months of age in four medically underserved areas.

OBJECTIVE: Risk factors for underimmunization at 3 months of age are not well described. This study examines coverage rates and factors associated with under-immunization at 3 months of age in four medically underserved areas. METHODS: During 1997-1998, cross-sectional household surveys using a two-stage cluster sample design were conducted in four federally designated Health Professional Shortage Areas. Respondents were parents or caregivers of children ages 12-35 months: 847 from northern Manhattan, 843 from Detroit, 771 from San Diego, and 1,091 from rural Colorado. A child was considered up-to-date (UTD) with vaccinations at 3 months of age if documentation of receipt of diphtheria-tetanus-pertussis, polio, haemophilus influenzae type B, and hepatitis B vaccines was obtained from a provider or a hand-held vaccination card, or both. RESULTS: Household response rates ranged from 79% to 88% across sites. Vaccination coverage levels at 3 months of age varied across sites: 82.4% in northern Manhattan, 70.5% in Detroit, 82.3% in San Diego, and 75.8% in rural Colorado. Among children who were not UTD, the majority (65.7% to 71.5% per site) had missed vaccines due to missed opportunities. Factors associated with not being UTD varied by site and included having public or no insurance, >/=2 children living in the household, and the adult respondent being unmarried. At all sites, vaccination coverage among WIC enrollees was higher than coverage among children eligible for but not enrolled in WIC, but the association between UTD status and WIC enrollment was statistically significant for only one site and marginally significant for two other sites. CONCLUSIONS: Missed opportunities were a significant barrier to vaccinations, even at this early age. Practice-based strategies to reduce missed opportunities and prenatal WIC enrollment should be focused especially toward those at highest risk of underimmunization.

California↗