Download or read book Rural Vs Urban Ambulatory Health Care written by U. S. Department of Veterans Affairs and published by Createspace Independent Pub. This book was released on 2013-05-23 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: Approximately 3 million veterans, slightly more than one-third of all veterans enrolled in the Department of Veterans Affairs (VA) health care system, live in rural areas. This pattern is likely to continue, as a comparable proportion of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans are from rural areas. The Rural Veterans Care Act of 2006 was signed into law to improve care for rural veterans. Ensuring that the health care needs of rural veterans are met has become a top priority for VA, resulting in a considerable expansion of community based outpatient clinics (CBOCs), inclusion of rural health/access as a research priority, and creation of the VA Office of Rural Health (ORH) in 2006. Although there have been reports comparing health quality of life (both physical and mental) for rural and urban veterans, it remains unclear whether the observed lower health quality of life in rural veterans is due to disparities in health care, differences in disease prevalence, or other population differences. This systematic review examines the evidence regarding potential disparities between rural and urban areas in health care provision and delivery, and how differences in health care may contribute to disparities in health outcomes. Differences in rural-urban prevalence rates of diseases and other health conditions are beyond the scope of this review. Because veterans who use VA health care have been found to use more non-VA health care overall, we expanded the focus of this review to include comparisons of rural vs. urban health care in non-VA health systems. Our first goal was to determine if a health care disparity exists across the urban-rural spectrum. For a disparity to exist, it would have to be demonstrated that health care outcomes of patients in rural areas differ from those of patients treated in urban areas for similar conditions. Because differences in health care process or delivery do not necessarily lead to disparities, we looked for evidence associating differences with poorer health outcomes. For the purposes of this review we conceptualized rural-urban disparities as differences in health care quality or availability. A second goal of the review was to identify areas for intervention should any disparities be found. In order to develop a meaningful intervention, specific information regarding differences in the structure of health care and the way it is administered (i.e., the process) would be critical. Since differences in health outcomes can occur for reasons other than differences in the health care systems themselves (e.g., accessibility), our third goal was to examine what, if any, nonhealth care factors (e.g., travel distance to a clinic) affected health outcomes. Because veterans who use VA health care actually use more non-VA health care overall,9 we expanded the focus of this review to include comparisons of rural vs. urban health care in non-VA health systems The key questions were: Key Question #1. Do adults with health care needs who live in rural areas have different intermediate (e.g., hemoglobin A1c [HbA1c], Blood pressure, etc.) or final health outcomes (i.e., mortality, morbidity, quality of life [QOL]) than those living in urban areas? Key Question #2. Is the structure (e.g., types of available providers) or the process (e.g., likelihood of referral) of health care different for adults with health care needs who live in urban vs. rural environments? Key Question #3. If there are differences in the structure or the process of health care in rural vs. urban environments, do those differences contribute to variation in overall or intermediate health outcomes for adults with health care needs? Key Question #4. If there are differences in intermediate or final health outcomes for adult patients with health care needs, what other systems factors moderate those differences (e.g., availability of specialists, type of treatment needed, travel distance)?
Download or read book Health Care in Urban and Rural Areas Combined Years 1998 2000 written by and published by . This book was released on 2004 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Quality Through Collaboration written by Institute of Medicine and published by National Academies Press. This book was released on 2005-04-24 with total page 289 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Building a Rural Health System written by United States. Health Services Administration. Bureau of Community Health Services and published by . This book was released on 1976 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Download or read book Defining rural Areas written by Maria Elizabeth Hewitt and published by . This book was released on 1989 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Quality Through Collaboration written by Institute of Medicine and published by National Academies Press. This book was released on 2005-03-24 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Redesigning the Clinical Effectiveness Research Paradigm written by Institute of Medicine and published by National Academies Press. This book was released on 2010-09-20 with total page 442 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent scientific and technological advances have accelerated our understanding of the causes of disease development and progression, and resulted in innovative treatments and therapies. Ongoing work to elucidate the effects of individual genetic variation on patient outcomes suggests the rapid pace of discovery in the biomedical sciences will only accelerate. However, these advances belie an important and increasing shortfall between the expansion in therapy and treatment options and knowledge about how these interventions might be applied appropriately to individual patients. The impressive gains made in Americans' health over the past decades provide only a preview of what might be possible when data on treatment effects and patient outcomes are systematically captured and used to evaluate their effectiveness. Needed for progress are advances as dramatic as those experienced in biomedicine in our approach to assessing clinical effectiveness. In the emerging era of tailored treatments and rapidly evolving practice, ensuring the translation of scientific discovery into improved health outcomes requires a new approach to clinical evaluation. A paradigm that supports a continual learning process about what works best for individual patients will not only take advantage of the rigor of trials, but also incorporate other methods that might bring insights relevant to clinical care and endeavor to match the right method to the question at hand. The Institute of Medicine Roundtable on Value & Science-Driven Health Care's vision for a learning healthcare system, in which evidence is applied and generated as a natural course of care, is premised on the development of a research capacity that is structured to provide timely and accurate evidence relevant to the clinical decisions faced by patients and providers. As part of the Roundtable's Learning Healthcare System series of workshops, clinical researchers, academics, and policy makers gathered for the workshop Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches. Participants explored cutting-edge research designs and methods and discussed strategies for development of a research paradigm to better accommodate the diverse array of emerging data resources, study designs, tools, and techniques. Presentations and discussions are summarized in this volume.
Download or read book Health Care in Rural America written by and published by . This book was released on 1990 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health needs and health services in rural America are key issues directly related to education as well as community well-being. This report examines rural America's access to basic health care services and discusses options for congressional consideration. The focus is on trends in availability of primary and acute rural health care and on factors affecting those trends. The report describes the characteristics of rural populations and health programs, the availability of rural health services and personnel, and delivery of rural maternal and infant health and mental health care services. On each subject, options for congressional action are examined. The federal government currently finances several different types of rural health care programs, and has a strong interest in health care trends. Major declines in inpatient utilization, compounded by increasing amounts of uncompensated care, have undermined the financial health of many rural hospitals, which also are faced with the outmigration of rural residents to urban areas for care. Policy reform options are presented in regard to: (1) improvement of rural health facilities; (2) availability and training of health professionals in rural areas; and (3) enhancing maternal and infant care programs and mental health care programs in rural areas. This document contains numerous charts, graphics, data tables, and appendices that present background information about the study. It also includes a 745-item bibliography and a subject index.
Download or read book Changing Numbers Changing Needs written by National Research Council and published by National Academies Press. This book was released on 1996-10-11 with total page 327 pages. Available in PDF, EPUB and Kindle. Book excerpt: The reported population of American Indians and Alaska Natives has grown rapidly over the past 20 years. These changes raise questions for the Indian Health Service and other agencies responsible for serving the American Indian population. How big is the population? What are its health care and insurance needs? This volume presents an up-to-date summary of what is known about the demography of American Indian and Alaska Native populationâ€"their age and geographic distributions, household structure, employment, and disability and disease patterns. This information is critical for health care planners who must determine the eligible population for Indian health services and the costs of providing them. The volume will also be of interest to researchers and policymakers concerned about the future characteristics and needs of the American Indian population.
Download or read book Understanding Racial and Ethnic Differences in Health in Late Life written by National Research Council and published by National Academies Press. This book was released on 2004-09-08 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.
Download or read book OECD Health Policy Studies Geographic Variations in Health Care What Do We Know and What Can Be Done to Improve Health System Performance written by OECD and published by OECD Publishing. This book was released on 2014-09-16 with total page 419 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report helps policy makers better understand the issues and challenges around geographic variations in health care provision and considers the policy options.
Download or read book Access to Health Care in America written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
Download or read book Retooling for an Aging America written by Institute of Medicine and published by National Academies Press. This book was released on 2008-09-27 with total page 317 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.
Download or read book Health Care Administration written by Lawrence F. Wolper and published by Jones & Bartlett Learning. This book was released on 2004 with total page 994 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Care Administration continues to be the definitive guide to contemporary health administration and is a must-have reference for students and professionals. This classic text provides comprehensive coverage of detailed functional, technical, and organizational matters.
Download or read book Implementing High Quality Primary Care written by National Academies of Sciences, Engineering, and Medicine and published by . This book was released on 2021-06-30 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.
Download or read book Health Care Comes Home written by National Research Council and published by National Academies Press. This book was released on 2011-06-22 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, health care devices, technologies, and practices are rapidly moving into the home. The factors driving this migration include the costs of health care, the growing numbers of older adults, the increasing prevalence of chronic conditions and diseases and improved survival rates for people with those conditions and diseases, and a wide range of technological innovations. The health care that results varies considerably in its safety, effectiveness, and efficiency, as well as in its quality and cost. Health Care Comes Home reviews the state of current knowledge and practice about many aspects of health care in residential settings and explores the short- and long-term effects of emerging trends and technologies. By evaluating existing systems, the book identifies design problems and imbalances between technological system demands and the capabilities of users. Health Care Comes Home recommends critical steps to improve health care in the home. The book's recommendations cover the regulation of health care technologies, proper training and preparation for people who provide in-home care, and how existing housing can be modified and new accessible housing can be better designed for residential health care. The book also identifies knowledge gaps in the field and how these can be addressed through research and development initiatives. Health Care Comes Home lays the foundation for the integration of human health factors with the design and implementation of home health care devices, technologies, and practices. The book describes ways in which the Agency for Healthcare Research and Quality (AHRQ), the U.S. Food and Drug Administration (FDA), and federal housing agencies can collaborate to improve the quality of health care at home. It is also a valuable resource for residential health care providers and caregivers.
