{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:57:38Z","timestamp":1791572258098,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010001","name":"Federal Office of Rural Health Policy","doi-asserted-by":"publisher","award":["U1CRH03712"],"award-info":[{"award-number":["U1CRH03712"]}],"id":[{"id":"10.13039\/100010001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To describe the mix of health professionals who care for rural and urban seniors suffering from mood and\/or anxiety disorders, the quantity of services they receive, and to understand where beneficiaries receive care for mood and\/or anxiety disorders and the distance and time they travel for care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used 2014 Medicare administrative claims data to examine access to health care for fee\u2010for\u2010service Medicare beneficiaries aged \u2265 65 years who received outpatient services for mood and anxiety disorders. We classified providers into 9 categories: (1) family physicians\/general practice, (2) internists, (3) nurse practitioners (NPs) and physician assistants (PAs), (4) psychiatrists, (5) psychologists, (6) clinical social workers, (7) emergency medicine physicians, (8) other physicians, and (9) other providers. We calculated the 1\u2010way driving distance and travel time between the beneficiary residence and provider location. We classified beneficiaries into 1 of 4 geographic categories based on their residence ZIP Code.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Urban beneficiaries had an average of 2.7 visits for mood and anxiety disorders, while rural beneficiaries had 2.4. Generalist physicians and NPs\/PAs provided 50.8% of all visits. Urban beneficiaries saw more behavioral health specialists (34.3%) than rural beneficiaries (16.1%). NPs and PAs provided more than twice as much of the care for rural beneficiaries (14.8%) as for urban beneficiaries (6.4%). Rural beneficiaries travelled about twice as far as urban beneficiaries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Rural and urban Medicare beneficiaries received care for mood\/anxiety disorders from different mixes of health care providers, and ensuring access for rural populations will require innovative solutions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12504","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T00:18:43Z","timestamp":1598573923000},"page":"692-699","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Comparing the Health Workforce Provider Mix and the Distance Travelled for Mental Health Services by Rural and Urban Medicare Beneficiaries"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9678-7933","authenticated-orcid":false,"given":"C. Holly A.","family":"Andrilla","sequence":"first","affiliation":[{"name":"WWAMI Rural Health Research Center Department of Family Medicine University of Washington School of Medicine  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Garberson","sequence":"additional","affiliation":[{"name":"WWAMI Rural Health Research Center Department of Family Medicine University of Washington School of Medicine  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davis G.","family":"Patterson","sequence":"additional","affiliation":[{"name":"WWAMI Rural Health Research Center Department of Family Medicine University of Washington School of Medicine  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim F.","family":"Quigley","sequence":"additional","affiliation":[{"name":"MEDEX Northwest Department of Family Medicine University of Washington School of Medicine  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric H.","family":"Larson","sequence":"additional","affiliation":[{"name":"WWAMI Rural Health Research Center Department of Family Medicine University of Washington School of Medicine  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Center for Behavioral Health Statistics and Quality.Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16\u20134984 NSDUH Series H\u201051).Rockville MD:SAMHSA;2016. 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WWAMI RUCA Rural Health Research Center. Available at:https:\/\/depts.washington.edu\/uwruca\/ruca-approx.php. Accessed July 24 2019."},{"key":"e_1_2_7_24_1","unstructured":"CromartieJ.2010 Rural\u2010Urban Commuting Area (RUCA) Codes. USDA Economic Research Service. Available at:https:\/\/www.ers.usda.gov\/data-products\/rural-urban-commuting-area-codes\/documentation\/. Accessed July 24 2019."},{"key":"e_1_2_7_25_1","unstructured":"SAS macro to calculate driving distance and travel time using Google Maps. SAS Community Libraries. Downloaded on 1\/31\/2018. Available at:https:\/\/www.sascommunity.org\/wiki\/Driving_Distances_and_Drive_Times_using_SAS_and_Google_Maps"},{"issue":"8","key":"e_1_2_7_26_1","first-page":"594","article-title":"Rural curricular guidelines based on practice scope of recent residency graduates practicing in small communities","volume":"49","author":"Skariah JM","year":"2017","journal-title":"Fam Med"},{"key":"e_1_2_7_27_1","volume-title":"Supply and Distribution of the Behavioral Health Workforce in Rural America. Data Brief #160","author":"Larson E","year":"2016"},{"key":"e_1_2_7_28_1","unstructured":"WeissAJ BarrettML HeslinKC StocksC.Trends in emergency department visits involving mental and substance use disorders 2006\u20132013. HCUP Statistical Brief #216. Rockville MD: AHRQ; December 2016. Available at:https:\/\/www.hcup-us.ahrq.gov\/reports\/statbriefs\/sb216-Mental-Substance-Use-Disorder-ED-Visit-Trends.pdf. 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