Quality Through Collaboration The Future of Rural Health (2005) / Chapter Skim
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1 Introduction
1 Introduction
Pages 19-29
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. Rural communities are a vital, diverse component of the United States, representing nearly 20 percent of the nation's population.
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For most rural communities, retaining workforce capacity and health care services -- whether primary care, emergency, hospital care, longterm care, mental health and substance abuse, oral health, or public health-has been a continuing challenge. RURAL HEALTH POLICY Making correct decisions on rural health policy is contingent on understanding the unique characteristics of the communities and conditions in which health care is delivered.
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undertake an independent, unbiased assessment of the condition of health and health care in rural America, and formulate an action plan for quality-focused rural community health systems. The charge to the committee included the following specific tasks: · Assess the quality of health care in rural areas; · Develop a conceptual framework for a core set of services and the essential infrastructure necessary to deliver those services to rural communities; · Recommend priority objectives, and identify the changes in policies and programs needed to accomplish those objectives, including, but not
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The committee recognizes the growing importance of ensuring a broad range of quality health care services for rural America; however, resource and time constraints, as well as a lack of sufficient data, prevented the committee from fully addressing the issues surrounding all the services, settings, and population groups that might be considered relevant to its charge. For instance, a comprehensive consideration of the availability and quality of longterm care, coordinated care for chronic diseases and disability, and quality monitoring and reporting systems need to be addressed by separate studies.
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The Quality Chasm report was a clarion call to improve the American health care delivery system as a whole along all of its quality dimensions. The report identifies six aims for quality improvement: health care should be safe, effective, patient-centered, timely, efficient, and equitable (see Table 1-1)
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: diabetes, asthma, heart disease, depression, and pain control in advanced cancer. The Fostering Rapid Advances report and the 1st Annual Crossing the Quality Chasm Summit report reflect a growing conviction on the part of many in the health care community that the health care system is too complex and geographically diverse to be reformed through national policy alone.
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· A core set of health care services (primary care, dental care, basic mental health care, and emergency medical services) should be available within rural communities.
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Both locally operated health systems and those that are part of networks spanning urban and rural communities should incorporate rural perspectives and local residents in their governing structures. Health literacy must be fostered in ways that acknowledge the culture of the rural population.
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The development of an information and communications technology infrastructure offers much potential to provide rural residents and their local providers with virtual access to specialists in outside areas, and to enhance the access of all providers to complete patient data and information in a timely fashion. Given their limited financial resources and the small scale of rural provider organizations, most rural health care systems will need financial and technical assistance to establish electronic health records and secure platforms for data exchange.
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Finally, the committee believes that broader health reform efforts focusing on both urban and rural communities would benefit from implementation of the health reform strategies proposed in this report for rural communities. Rural communities represent excellent sites to pilot innovative ways of improving population health and personal health care delivery, given the smaller scale of rural health care and the strong sense of community in rural areas.
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2003. Transforming the delivery of rural health care in Georgia: State partnership strategy for developing rural health networks.
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