Ll. Hicks et al., A method for identifying comparison counties: application to a rural telemedicine evaluation project, J TELEMED T, 5(3), 1999, pp. 182-188
The evaluation of telemedicine activity in rural communities is complicated
by the fact that most telemedicine sites are chosen because of their exist
ing telecommunications infrastructure and institutional relationships, not
by a random selection process. In addition, it is difficult to draw conclus
ions about the effects of telemedicine without a careful analysis of parall
el changes in communities which do not have access to telemedicine services
. We have developed a method of identifying comparable counties based on an
aggregate measure of health status. A set of 66 variables was collected in
a previous project to develop a model to evaluate the relative health stat
us of the population in Missouri. A stepwise regression was used to identif
y a subset of 15 variables that had the highest predictive value for the he
alth status of a county. Distance measures were then used to identify six c
ounties which were most similar to three telemedicine counties. The method
can be used with any study set chosen non-randomly, to identify similar obj
ects that can be used for comparative purposes.