has been a vexing challenge for clinicians and patients for many years. There is a chronic shortage of specialty mental health providers, particularly psychiatrists and psychologists, which has shifted much of the burden of care to primary care. Primary care clinicians have historically lacked the training and time within their busy practices to feel comfortable providing mental healthcare, par...

In this policy brief we analyze the effect of Medicare payment adjustments on Medicare-derived revenues to rural primary care providers. Building on prior work in this area, we look at the effect of changes in the Geographic Practice Cost Indices (GPCIs) from 2013 to 2014 as implemented in the Pathway for SGR Reform Act of 2013 and the Protecting Access to Medicare Act. Key Findings. (1) Change...

iran is a large country with a total area of 1,645,000 square kilometers. the country’s population is estimated at about 31 millions. there is an uneven distribution of the population, varying from 2 to 50 per square kilometer. sixty per cent of the total population (18 millions) is living in nearly 66,000 small and large village’s scattered throughout the country. a total of 10,000 physicians ...

Beginning with a brief overview of national health care quality improvement efforts, this article describes national initiatives to improve the quality of care and patient safety, along with the challenges of measuring quality of care in rural settings. Next, the article analyzes the performance of rural Minnesota hospitals in the Hospital Compare and Leapfrog initiatives and compares the resul...

OBJECTIVES To examine the prevalence of parent-reported emotional and behavior problems in pediatric primary care clinics serving rural Appalachia using methods commensurate with studies of broader samples. METHODS Parents presenting to pediatric primary care clinics completed a rating scale (Pediatric Symptom Checklist) of psychosocial problems for their child. RESULTS Approximately 21% of...