S.W.'s research was supported in part by the National Cancer Institute (CA-57030) and the Texas A&M University Center for Environmental and Rural Health to do statistical methodology research and its application to the health sciences.
Urban/Rural Differences in Decision Making and the Use of Advance Directives Among Nursing Home Residents at Admission
Article first published online: 6 JUN 2006
The Journal of Rural Health
Volume 20, Issue 2, pages 131–135, March 2004
How to Cite
Buchanan, R. J., Bolin, J., Wang, S., Zhu, L. and Kim, M. (2004), Urban/Rural Differences in Decision Making and the Use of Advance Directives Among Nursing Home Residents at Admission. The Journal of Rural Health, 20: 131–135. doi: 10.1111/j.1748-0361.2004.tb00019.x
- Issue published online: 6 JUN 2006
- Article first published online: 6 JUN 2006
ABSTRACT: Context: Advance directives promote patient autonomy and encourage greater awareness of final care options while reducing physician and family uncertainty regarding patient preferences. Purpose: To investigate differences in decision making authority and the use of advance directives among nursing home residents admitted from urban and rural areas. Methods: A total of 551,208 admission assessments in the Minimum Data Set were analyzed for all residents admitted to a nursing facility in 2001. Using the Rural Urban Commuting Areas (RUCA) methodology and ZIP code of primary residence before admission, these residents were classified into 4 urban/rural areas. Findings: Residents from rural areas were significantly more likely to have executed a durable power of attorney for health care or for financial decisions than residents admitted from the other areas, with the largest differences observed between residents admitted from urban and rural areas. Almost 6 residents in 10 from urban areas had no advance directives in place at admission compared with only 4 residents in 10 admitted from rural areas. Conclusions: Health providers and social workers in both rural and urban areas should advise patients about the value of advance directives.