Term Paper on "Rural Healthcare"

Term Paper 20 pages (5552 words) Sources: 10 Style: APA

[EXCERPT] . . . .

Rural Healthcare Facilities

Context of the Problem

Twenty-five percent of the total population in the United States are living in rural areas and compared with urban Americans and healthcare facilities in rural areas generally serve low-income, the elderly, and individuals who are less informed and armed with less knowledge concerning health care prevention measures. Moreover, rural individuals accessing healthcare in rural facilities face barriers to healthcare such as fewer doctors, hospitals and health resources in generation and face difficulty in accessing health services.

Hospital closures and other market changes have adversely affected rural areas, leaving State and Federal policymakers, and others concerned about access to health care in rural America. Considerable changes in the health care delivery system over the past decade have intensified the need for new approaches to health care in rural areas. Managed care organizations, for example, may not be developed easily in rural areas, partly because of low population density.

Research Questions

The primary research question in this study is the question of whether rural health care facilities overcome the ongoing challenges to provide quality medical care to their communities?

Rationale of the Research

The rationale of this research is based upon the following facts:

1.) Rural Healthcare and Barriers to Accessing Care: Many small rural hospitals have closed, while other health care supply of primary care physicians and other health care providers facilities are in financial strait

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s. Unavailability of resources and transportation problems are barriers to access for rural populations.

2.). The supply of primary care practitioners and other health care providers in rural areas is decreasing. Some are leaving rural areas to join managed care organizations elsewhere.

3.) Barriers to Health Promotion and Disease Prevention. Goals for improving the Nation's health over the next decade can be achieved only if rural populations are included in efforts to remove barriers to access and use of clinical preventive services.

4.) Barriers Related to Lack in Health Care Technology. Technologies including telemedicine offer promise of improved access to health care, but their most efficient and effective applications need further evaluation.

5.) Organizational Barriers of Service Provision to Vulnerable Rural Populations: Low population density in rural areas makes it inherently difficult to deliver services that target persons with special health needs. Groups at particular risk include: the elderly; the poor; people with HIV or AIDS; the homeless; mothers, children, and adolescents; racial or ethnic minorities; and persons with disabilities.

6.) Consumer choice and the rural hospital. Factors that drive changes in rural hospitals have a critical effect on consumer choice and access.

Significance of the Study

This study is significant in that individuals in rural areas are likely to continue to receive less healthcare as well as less effective healthcare if rural healthcare does not gain necessary knowledge, informed by research study as to what should be done to better deliver health care services to those in rural areas. This study is of significance to several groups including patients depending on rural healthcare services, the families of these patients, the rural communities at large and the insurance companies who provide insurance coverage for individuals in rural areas.

Methodology

The methodology of the proposed research is one of a qualitative nature in which data will be gathered through survey/questionnaires of individuals, physicians and business in the rural community at focus in the research in order to asses whether the needs of the community in terms of healthcare provision are being met. Data analysis will be both qualitative and quantitative in nature. After having administered and compiled data from the survey/questionnaires focus groups will be scheduled to gain further insight into the unmet needs of the community in health care services in needs assessment focus group discussions.

Literature Review

The California Healthcare Foundation, in its "Rural Health Care Delivery: Connecting Communities through Technology" report of December 2002 states

Challenges facing rural health care include scarcity of local medical resources and distance between patients, physicians and facilities." (Turisco and Metzger, 2002) Furthermore, it is related in this report that there are insufficient numbers of primary care practitioners in rural areas. (Turisco and Metzger, 2002; paraphrased) in the instance where a patient is forced to travel from home to another area for accessing health care services resulting is a "range of difficulties" including: (1) time away from work; (2) additional expenses; and (3) the complications of coordinating care in different locales." (Turisco and Metzger, 2002) This increases the chance the patient information will come up missing or incomplete and as well may result in care that is "delayed or fragmented." (Turisco and Metzger, 2002) the physicians in rural areas as well as other health care providers experience negative impacts due to the low number of health care practitioners in rural areas as well as in the distance factor, which results in "limitations on productivity, communication and ongoing education." (Turisco and Metzger, 2002) Research notes that there is more difficulty for the rural providers in communication with other providers of health care. There is much less in the way of opportunities to attend conferences and training due to the requirements of travel, which limits access to medical knowledge and research work. Lower efficiency results due to travel time involved in visiting patients in hospitals and nursing homes as well as in "...fewer face-to-face visits, and more time on the telephone with other providers and with patients." (Turisco and Metzger, 2002)

In a recent report relating to healthcare in rural India stated is that: "The number of patients is increasing exponentially each year, putting enormous pressure on healthcare delivery systems worldwide. Hospitals and specialists are concentrated in cities and are inaccessible to the rural poor." (Tata Consultancy Services and Microsoft Corporation, nd) This report relates that several physicians in India along with Tata Consultancy Services (TCS) and the largest it company in India collaborated in the creation of WebHealthCentre.com which is stated to be: "...a comprehensive healthcare portal like no other." (Tata Consultancy Services and Microsoft Corporation, nd) Offered are "abundant health-related reference material, online medical consultation, online appointment scheduling, and online lab results for physicians." (Tata Consultancy Services and Microsoft Corporation, nd) the WebHealthCentre.com website was stated to have been created with the Microsoft.NET Framework, Microsoft Windows 2000 Advanced Server, Web services and Microsoft SQL Server 2000. The requirements set out by the physicians in rural areas included:

Ease of use by a wide cross section of people;

Cutting-edge yet cost-effective technologies;

Simple log on by many different users and easy assignment of user rights;

Tight security to keep medical records confidential;

Structured data capture for future data mining;

Scalable to handle millions of users; and Extensible to accommodate audio and video interface. (Tata Consultancy Services and Microsoft Corporation, nd)

Benefits resulting from implementation of this healthcare service delivery Network include:

Improved access to healthcare;

Better use of doctors' time;

Rapid development, usability;

Scalable to millions of patients; and Extensible to new technologies. (Tata Consultancy Services and Microsoft Corporation, nd)

Key features of WebHealthCentre.com are stated to include the following:

Online, real-time medical consultation with remote healthcare professionals.

PC or mobile-phone access to regional directories for hospitals, specialists, blood banks, medical appliance suppliers, and welfare agencies.

An online appointment scheduler that enables patients to make appointments with participating physicians.

An online lab report tool that helps diagnostic centers automate the process of uploading lab reports to the Web.

Access to test results through mobile devices.

Online access to electronic health records.

Medical image upload services.

Online sonogram viewing.

A medical student resource center.

Healthcare job listings.

Online shopping for healthcare supplies. (Tata Consultancy Services and Microsoft Corporation, nd)

The Agency for Healthcare Research and Quality (AHRQ) held an expert panel meeting to provide guidance on its new health information technology on July 23-24-2003. The focus of AHRQ is the implementation and evaluation of technologies, which have been shown to be effective in small and rural communities. Secondly, the AHRQ has set its' focus upon supporting advancement in the HIT field through implementation and evaluation support for innovation in technologies for use in diverse health care settings." (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) the Meeting Summary reports that "two general themes emerged from the discussion" which are those of: (1) Bringing people together; and (2) Providing technical assistance. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Activities recommended for achieving their goals are those as follows:

Support demonstration projects that involve HIT implementation and will lead to the creation of learning networks comprised of providers from various types of rural health care organizations.

Create learning communities that span geography; collect and analyze the outcomes associated with participation.

Once factors that facilitate learning communities and HIT implementation have been identified, engage CMS and other purchasers to define an appropriate reimbursement strategy.

Incorporate evidence-based primary care guidelines with rural relevance into technological templates. Clinicians are likely to accept clinical guidelines offered by the Federal Government at no cost.

Support local capacity development for HIT, including barrier analysis, education and other… READ MORE

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Quoted Instructions for "Rural Healthcare" Assignment:

“

STRAYER UNIVERSITY

A STUDY OF THE CHALLENGES FACED BY RURAL HEALTHCARE FACILITIES.

A DIRECTED RESEARCH PROJECT SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL OF HEALTH SERVICES IN PREPARATION OF FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF HEALTH SERVICES ADMINISTRATION

TO

DR. BELINDA HARTNETT

BY

JOHN G. COGLIANO

LAUGHLIN NV

DATE

TABLE OF CONTENTS

TABLE OF CONTENTS

PROPOSAL

PROPOSAL

Context of the Problem

One-fourth of America's population lives in rural areas. Compared with urban Americans, rural residents have higher poverty rates, a larger percentage of elderly, tend to be in poorer health, have fewer doctors, hospitals, and other health resources, and face more difficulty getting to health services.

Statement of the problem

Hospital closures and other market changes have adversely affected rural areas, leaving State and Federal policymakers, and others concerned about access to health care in rural America. Considerable changes in the health care delivery system over the past decade have intensified the need for new approaches to health care in rural areas. Managed care organizations, for example, may not be developed easily in rural areas, partly because of low population density.

Main Research Questions and Sub-Questions

Can rural health care facilities overcome the ongoing challenges to provide quality medical care to their communities?

The subsequent six research sub questions of this study are formulated in the following way:

1.) Access to care. Many small rural hospitals have closed, while other health care Supply of primary care physicians and other health care providers facilities are in financial straits. Unavailability of resources and transportation problems are barriers to access for rural populations.

2.). The supply of primary care practitioners and other health care providers in rural areas is decreasing. Some are leaving rural areas to join managed care organizations elsewhere.

3.) Health promotion and disease prevention. Goals for improving the Nation's health over the next decade can be achieved only if rural populations are included in efforts to remove barriers to access and use of clinical preventive services.

4.) Health care technology. Technologies including telemedicine offer promise of improved access to health care, but their most efficient and effective applications need further evaluation.

5.) Organization of services for vulnerable rural populations. Low population density in rural areas makes it inherently difficult to deliver services that target persons with special health needs. Groups at particular risk include: the elderly; the poor; people with HIV or AIDS; the homeless; mothers, children, and adolescents; racial or ethnic minorities; and persons with disabilities.

6.) Consumer choice and the rural hospital. Factors that drive changes in rural hospitals have a critical effect on consumer choice and access.

Significance of the Study

This study is of significance to several groups including:

Patients (both present and future)

Families of Patients

Communities

Insurance Companies

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