153038 Rural analyses of data from a Medicare demonstration: Overview and conceptual framework

Wednesday, November 7, 2007: 12:47 PM

Brenda R. Wamsley, PhD , Department of Social Work, West Virginia State University, Institute, WV
This paper presents an overview of the key components of the Medicare Primary and Consumer-Directed Care Demonstration (N=1,604), a CMS-funded study conducted in WV, NY and OH with beneficiaries identified as having moderate to severe functional impairment. A conceptual framework is provided with special attention to a health promotion nurse/disease self-management intervention (Nurse Group). A definition of rural is provided along with key characteristics of rural Medicare beneficiaries. A brief summary of earlier findings of rural analyses is reviewed as background for the new findings being presented in this Symposium. Earlier findings showed that rural participants in the Nurse Group reported significantly less decline in activities of daily living (ADLS) compared to controls (p=0.02). This finding held when looking at rural sub-groups, such as those with heart conditions (p=0.04) and those with hypertension (p=0.07). Similar findings were not found in the urban sample. A summary of earlier findings related to cost and service use patterns is also provided as further background for the papers that will follow this overview and introduction.

Learning Objectives:
At the end of this presentation, the participant will be able to: 1. Explain the conceptual framework for the health promotion nurse/disease self-management intervention; 2. Provide a definition of rural along with key aspects and characteristics of rural Medicare beneficiaries; and 3.Discuss key findings related to the effectiveness of the nurse group intervention on preventing functional decline in a rural sub-sample without significantly increasing costs to Medicare.

Keywords: Health Promotion, Rural Health

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.