A method for identifying comparison counties: application to a rural telemedicine evaluation project

Area of Science:

• Health Services Research
• Rural Health
• Telemedicine

Background:

• Evaluating telemedicine's impact in rural communities is complex.
• Non-random site selection and lack of control groups hinder accurate assessment.
• Existing telecommunications and institutional ties often dictate telemedicine site choice, not representativeness.

Purpose of the Study:

• To develop a robust method for identifying comparable control counties for telemedicine studies.
• To address the challenge of non-randomized study designs in telemedicine research.
• To enable more accurate evaluation of telemedicine's effects in rural populations.

Main Methods:

• Collected 66 health status variables for Missouri counties.
• Utilized stepwise regression to identify 15 key health status predictors.
• Employed distance measures to find counties comparable to telemedicine sites.

Main Results:

• Developed a health status aggregate measure for county comparison.
• Successfully identified six comparable control counties for three telemedicine counties.
• Demonstrated a viable method for selecting control groups in non-randomized studies.

Conclusions:

• The developed method provides a reliable approach to identify comparable counties for telemedicine research.
• This technique is applicable to any non-randomly chosen study set requiring comparative analysis.
• Enhances the ability to draw valid conclusions about telemedicine's effectiveness in rural settings.