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Many of the 61 million people who live in rural America have limited access to health care. Almost a quarter of the nation's population lives in rural places yet only an eighth of our doctors work there. Sponsored by the U.S. Office of Rural Health Policy, this unique book provides the facts about this imbalance and interprets them in the context of government programs that promote the placement of doctors and the operation of hospitals in rural places while paying them less to treat Medicare and Medicaid beneficiaries. The authors' comprehensive analysis of rural health care delivery shows where there are differences in rates of death and disease between rural areas using maps, graphs, and plain-English descriptions. The book provides a thorough look at health care in rural America, giving a snapshot of how doctors, hospitals, and technology are unevenly distributed outside the nation's metropolitan areas.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.
Accompanying CD-Rom has same title as book.
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In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
Klugman and Dalinis initiate a much-needed conversation about the ethical and policy concerns facing health care providers in the rural United States. This volume initiates a much-needed conversation about the ethical and policy concerns facing health care providers in the rural United States. Although 21 percent of the population lives in rural areas, only 11 percent of physicians practice there. What challenges do health care workers face in remote locations? What are the differences between rural and urban health care practices? What particular ethical issues arise in treating residents of small communities? Craig M. Klugman and Pamela M. Dalinis gather philosophers, lawyers, physicians, nurses, and researchers to discuss these and other questions, offering a multidisciplinary overview of rural health care in the United States. Rural practitioners often practice within small, tight-knit communities, socializing with their patients outside the examination room. The residents are more likely to have limited finances and to lack health insurance. Physicians may have insufficient resources to treat their patients, who often have to travel great distances to see a doctor. The first part of the book analyzes the differences between rural and urban cultures and discusses the difficulties in treating patients in rural settings. The second part features the personal narratives of rural health care providers, who share their experiences and insights. The last part introduces unique ethical challenges facing rural health care providers and proposes innovative solutions to those problems. This volume is a useful resource for bioethicists, members of rural bioethics committees and networks, policy makers, teachers of health care providers, and rural practitioners themselves.
Rural counties make up about 80 percent of the land area of the United States, but they contain less than 20 percent of the U.S. population. The relative sparseness of the population in rural areas is one of many factors that influence the health and well-being of rural Americans. Rural areas have histories, economies, and cultures that differ from those of cities and from one rural area to another. Understanding these differences is critical to taking steps to improve health and well-being in rural areas and to reduce health disparities among rural populations. To explore the impacts of economic, demographic, and social issues in rural communities and to learn about asset-based approaches to addressing the associated challenges, the National Academies of Sciences, Engineering, and Medicine held a workshop on June 13, 2017. This publication summarizes the presentations and discussions from the workshop.
A comprehensive resource describing innovative technologies and digital health tools that can revolutionize the delivery of health care in low- to middle-income countries, particularly in remote rural impoverished communities Revolutionizing Tropical Medicine offers an up-to-date guide for healthcare and other professionals working in low-resource countries where access to health care facilities for diagnosis and treatment is challenging. Rather than suggesting the expensive solution of building new bricks and mortar clinics and hospitals and increasing the number of doctors and nurses in these deprived areas, the authors propose a complete change of mindset. They outline a number of ideas for improving healthcare including rapid diagnostic testing for infectious and non-infectious diseases at a point-of-care facility, together with low cost portable imaging devices. In addition, the authors recommend a change in the way in which health care is delivered. This approach requires task-shifting within the healthcare provision system so that nurses, laboratory technicians, pharmacists and others are trained in the newly available technologies, thus enabling faster and more appropriate triage for people requiring medical treatment. This text: Describes the current burden of communicable and non-communicable diseases in low- to middle-income countries throughout the world Describes the major advances in healthcare outcomes in low-to middle-income countries derived from implementation of the United Nations/World Health Organisation’s 2000 Millennium Development Goals Provides a review of inexpensive rapid diagnostic point-of-care tests for infectious diseases in low-resource countries, particularly for people living in remote rural areas Provides a review of other rapid point-of-care services for assessing hematological function, biochemical function, renal function, hepatic function and status including hepatitis, acid-base balance, sickle cell disease, severe acute malnutrition and spirometry Explores the use of low-cost portable imaging devices for use in remote rural areas including a novel method of examining the optic fundus using a smartphone and the extensive value of portable ultrasound scanning when x-ray facilities are not available Describes the use of telemedicine in the clinical management of both children and adults in remote rural settings Looks to the future of clinical management in remote impoverished rural settings using nucleic acid identification of pathogens, the use of nanoparticles for water purification, the use of drones, the use of pulse oximetry and the use of near-infrared spectroscopy Finally, it assesses the potential for future healthcare improvement in impoverished areas and how the United Nations/World Health Organization 2015 Sustainable Development Goals are approaching this. Written for physicians, infectious disease specialists, pathologists, radiologists, nurses, pharmacists and other health care workers, as well as government healthcare managers, Revolutionizing Tropical Medicine is a new up-to-date essential and realistic guide to treating and diagnosing patients in low-resource tropical countries based on new technologies.
Health-related disparities remain a persistent, serious problem across the nation's more than 60 million rural residents. Rural Populations and Health provides an overview of the critical issues surrounding rural health and offers a strong theoretical and evidence-based rationale for rectifying rural health disparities in the United States. This edited collection includes a comprehensive examination of myriad issues in rural health and rural health care services, as well as a road map for reducing disparities, building capacity and collaboration, and applying prevention research in rural areas. This textbook offers a review of rural health systems in Colorado, Kentucky, Alabama, and Iowa, and features contributions from key leaders in rural public health throughout the United States. Rural Populations and Health examines vital health issues such as: Health assessment Strategies for building rural coalitions Promoting rural adolescent health Rural food disparities Promoting oral health in rural areas Physical activity in rural communities Preventing farm-related injuries Addressing mental health issues Cancer prevention and control in rural communities Reducing rural tobacco use Rural Populations and Health is an important resource for students, faculty, and researchers in public health, preventive medicine, public health nursing, social work, and sociology.