An Epidemiologic Approach to Assessing Primary Care Needs in Rural Illinois (original) (raw)
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The Journal of rural health, 1996
As the national health debate evolved over the past two years, a need to better understand the differential constraints of rural health delivery and popular attitudes toward policy initiatives became apparent. Selected 1994 and 1995 results of two national suroeys designed to compare rural and urban household responses are reported. The average distance those living in rural households must travel to access medical providers and emergency care is nearly double that of urban household residents. Rural household resident responses show a higher level of acceptance of nonphysician health care providers such as physicians assistants and registered nurses. Means testing of Medicare programs and use of special indicators for providing more Medicaid funds to states with medically underserved and sparsely populated areas are examples of two policy initiatives that receive favorable responses from both urban and rural household residents, but would disproportionately benefit rural areas. This project was supported by the Rural Policy Research Institute, the North Central Regional Center for Rural Development, the Farm Foundation and law State University. The authors would like to acknowledge helpful contributions by Charles Fluharty,
The Role of Federally Funded Health Centers in Serving the Rural Population
The Journal of Rural Health, 2003
Context: Federally funded health centers attempt to improve rural health by red and eliminating access barriers to prima y care services. Purpose: This study compares rural health center patients with people in the general rural population for indicators of access to preventive services and health outcomes. Methods: Data from the distribution of rural areas (14.6% over age 65 versus 11.8% for the n a t i~n ) .~ Living in a rurally designated area with smaller populations and greater dispersion, residents face unique geographic access barriers, with considerable travel distance and transportation problem^.^ Further, rural areas constitute more than 75% of counties
Health Care’s Role in the Rural Illinois Economy
The federal government's economic data system counts Medicare and Medicaid payments to healthcare providers as income to the residents who are beneficiaries of the services. These payments in essence act as income to these individuals. A basic question in rural economic development in the United States today is "What is the role of health care in community development efforts?" As the largest industry in the United States and one projected to grow even larger during the coming decades, every rural community must assess its ability to benefit from these healthcare changes. In almost every rural community, health care will play a role in economic development. In some places, it may be the dominant employer and source of economic growth. In other places, this industry will be a small part of the local economic picture. Regardless, communities should actively plan and assess the role of health care in their economy. Fall 2004 Volume 16, Issue 1 The Rural Research Report is a series published by the Illinois Institute for Rural Affairs to provide brief updates on research projects conducted by the Institute. Rural Research Reports are peer-reviewed and distributed to public officials, libraries, and professional associations involved with specific policy issues.
Evaluation and Program Planning, 2019
This rubric can be used by providers, decision makers, policymakers, agencies, communities themselves, and other key stakeholders in rural areas to standardize and prioritize strategies to improve access to care in their communities. Use of the rubric can inform decision making processes by providing evidence-based, comparable results pertaining to the impact and feasibility of pertinent access to care improvement strategies. The rubric can be further modified to meet the specific population and/or health needs of each community. In the long-term, this rubric could facilitate discussions of strategy implementation successes and opportunities for improvement between rural communities.
An Innovative Community-based Model for Improving Preventive Care in Rural Counties
The Journal of the American Board of Family Medicine
This quasi-experimental pilot study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices (PCPs) located in a rural county in Oklahoma. A Wellness Coordinator (WC) working with PCPs, the county health department, the county hospital, and a health information exchange (HIE) organization helped county residents receive evidence-based preventive services. Methods: The WC used a community wellness registry connected to electronic medical records via HIE and called patients at the county level based on PCP-prioritized and tailored protocols. The registry flagged patient-level preventive care gaps, tracked outreach efforts, and documented the delivery of preventive services throughout the community. Return on investment (ROI) for prioritized preventive services was estimated in participating organizations. Results: Six of the 7 PCPs in the county expressed interest in the project. Three of these practices fully implemented the 1-year outreach program starting in mid 2015. The regional HIE supplied periodic data updates for 9138 county residents to help the coordinators address care gaps using the community registry. A total of 5034 outreach calls were made by the WC in the first year and 7776 prioritized recommendations were offered when care gaps were detected. Of the 5034 distinct patients who received a call, 1146 (22%) were up to date on all prioritized services, whereas 3888 (78%) were due for at least 1 of the selected services. Health care organizations in the county significantly improved the delivery of selected preventive services (mean increase, 35% across 10 services; P ؍ .004; range, 3% to 215%) and realized a mean ROI of 80% for these services (range, 32% to 122%). The health system that employed the WC earned an estimated revenue of $52,000 realizing a 40% ROI for the coordinator position. Conclusions: Although more research is needed, our pilot study suggests that it may be feasible and cost effective to implement an innovative, county-level patient outreach program for improving preventive care in rural settings.
Multi-method assessment of access to primary medical care in rural Colorado
1999
The objectives of this study include conducting an analysis of access to primary medical care in rural Colorado through simultaneous consideration of primary care physicianto-population and distance-to-nearest provider indices. Analyses examined the potential development and implications of excessively large, perhaps unmanageable patient caseloads that might result from every rural Coloradoan's exclusive use of the nearest generalist physician as a regular source of care. Using American Medical Association Physician Masterfile data for 1995 and coordinates for latitude and longitudefrom U.S. Census files (Census of Population and Housing, 1990), the authors calculated distance to the nearest primary care physician for residents of each of the 1,317 block groups in Colorado's 52 rural counties. Caseloads for each generalist physician were computed assuming the population used the nearest provider for care. Straight-line mileage to primary medical care was modest for rural Coloradoans-+ median distance of 2.5 miles. Almost two-thirds (65 percent) of the population resided within 5 miles, and virtually all residents (99 percent) were within 30 miles of a generalist physician. However, had everyone traveled the shortest possible distance to care, demand for service from many of the 343 primary care doctors in rural regions of the state would have been overwhelming. The results of simultaneous appzication of distance-to-care and provider-to-population techniques unrestricted by geographic boundaries depict access to primary medical care and corresponding consumer difftculty more furry than in previous studies. Further combination of methods of needs assessment such as those used in this analysis may better inform thefuture efforts of organizations mandated to address health care underservice in rural areas. urrent and future U.S. physician work force requirements have recently been estimated using a variety of methods and assumptions
Continuing Challenges in Rural Health in the United States
Journal of environment and health sciences, 2019
Estimates of the total U.S. population living in non-metropolitan (rural) counties vary from 46.2 million to 59 million people. This represents 14% to 19% of the U.S. population. A recent AAMC report (Warshaw, 2017) addresses some of the challenges of rural health and associated health disparities affecting millions in the U.S. Rural populations are culturally heterogeneous, are spread broadly across large areas of the U.S., and have different demographics (Douthit et al., 2015). Compared to urban areas, rural communities face higher poverty rates, lower educational attainment, lack of transportation, a higher proportion of elderly individuals, and lack of access to health services (Hunsaker & Kantayya, 2010; Ricketts, 2000). Owing to these factors, rural communities face elevated rates of morbidity and mortality and greater percentages of excess deaths from the five leading causes of death including cancer and cardiovascular disease (Garcia et al., 2019).