Rural Vs. Urban Ambulatory Health Care PDF Download
Are you looking for read ebook online? Search for your book and save it on your Kindle device, PC, phones or tablets. Download Rural Vs. Urban Ambulatory Health Care PDF full book. Access full book title Rural Vs. Urban Ambulatory Health Care by U. S. Department of Veterans Affairs. Download full books in PDF and EPUB format.
Author: U. S. Department of Veterans Affairs
Publisher: Createspace Independent Pub
ISBN: 9781489553348
Category : Medical
Languages : en
Pages : 104
Get Book Here
Book Description
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)?
Author: U. S. Department of Veterans Affairs
Publisher: Createspace Independent Pub
ISBN: 9781489553348
Category : Medical
Languages : en
Pages : 104
Get Book Here
Book Description
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)?
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 100
Get Book Here
Book Description
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.
Author:
Publisher:
ISBN:
Category : Medical care
Languages : en
Pages : 52
Get Book Here
Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309094399
Category : Medical
Languages : en
Pages : 289
Get Book Here
Book Description
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.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161
Get Book Here
Book Description
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.
Author: Maria Elizabeth Hewitt
Publisher:
ISBN:
Category : Federal aid to rural health services
Languages : en
Pages : 76
Get Book Here
Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309133475
Category : Medical
Languages : en
Pages : 288
Get Book Here
Book Description
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.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030911988X
Category : Medical
Languages : en
Pages : 442
Get Book Here
Book Description
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.
Author:
Publisher:
ISBN:
Category : Federal aid to rural health services
Languages : en
Pages : 548
Get Book Here
Book Description
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.
Author: National Research Council
Publisher: National Academies Press
ISBN: 0309165865
Category : Social Science
Languages : en
Pages : 184
Get Book Here
Book Description
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.
