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Janice C Probst

Publications and source records attributed to Janice C Probst.

23 records · Page 2Linked to original sources
PubMed2002

Rural-urban differences in visits to primary care physicians.

BACKGROUND AND OBJECTIVES: Our study explored ambulatory practice differences between rural and urban primary care physicians. Because most rural practitioners are not educated through special rural tracks, all primary care medical educators need to ensure that training prepares physicians for the demands of rural sites. METHODS: Visits to family, general practice, internal medicine, and pediatric physicians from the 1996 and 1997 National Ambulatory Medical Care Surveys were analyzed. "Rural" was defined as outside a metropolitan statistical area. RESULTS: Family physicians handled the majority of rural visits, even among pediatric populations. Acute injuries represented 6.1% of rural visits versus 5.0% of urban visits. Conditions likely to be associated with pain (degenerative joint disease, low-back pain, myalgias, headaches, and bursitis) were higher among rural visits (8.5% versus 5.4% urban). Preventive counseling and services and anticipatory guidance for children were provided less frequently in rural visits. CONCLUSIONS: Physicians entering rural primary care practice need training in acute injury and chronic pain syndromes, as well as ample exposure to care for children. Research is needed to explain the less-frequent provision of clinical preventive services in rural areas. Given clinical similarities between rural and urban visit content, subtle differences in provision of acute care and preventive services may provide important clues to training needs among physicians preparing to enter rural practice.

Adolescent↗
PubMedDate not supplied

Barriers associated with the delivery of Medicare-reimbursed diabetes self-management education.

PURPOSE: The purpose of this study was to explore the barriers that practitioners face in providing diabetes self-management education (DSME) to Medicare beneficiaries, with a special focus on barriers faced by rural providers. METHODS: Using an e-mail survey, Diabetes Control Program Coordinators (DCPCs) in all US states were asked 3 open-ended questions to understand problems with obtaining American Diabetes Association (ADA) recognition for Medicare reimbursement, differences in obtaining ADA recognition by rural and urban facilities, and facility-level barriers to providing DSME to Medicare patients. Using a mail survey administered to half of ADA-recognized diabetes education centers (DECs), information was collected about perceived barriers to providing DSME in all areas and rural areas. RESULTS: Most DCPCs believed it was more difficult for rural providers to obtain ADA recognition than for urban providers; the largest barriers were costs and reporting requirements. The top barriers for rural providers mentioned by DCPCs were the shortage of designated specialists, fewer resources, and high application fees for ADA recognition. Barriers identified by DEC respondents facing rural providers include staffing/institutional support, amount of Medicare reimbursement, lack of hours covered, and transportation. DEC respondents providing care in urban areas only were more likely to perceive barriers to providing diabetes education in rural areas than were rural providers. CONCLUSIONS: Barriers to DSME are perceived to be higher for rural providers than urban providers. Urban providers perceived that many barriers to DSME are greater for rural providers. The ADA application process is perceived as expensive and laborious. Most respondents perceived Medicare reimbursement for DSME as inadequate.

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