[Problems and Solution in Rural Healthcare Delivery]

by



Acknowledgement

I would take this opportunity to thank my research supervisor, family and friends for their support and guidance without which this research would not have been possible.

DECLARATION

I, [type your full first names and surname here], declare which the contents of this dissertation/thesis represent my own unaided work, and which the dissertation/thesis has not previously been submitted for academic examination towards any qualification. Furthermore, it represents my own opinions and not necessarily those of the University.

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Abstract

This study offers an overview of the health status of rural populations and its major determinants in U.S. A wide range of indicators are examined along a spatial grid that allows rural as well as intrarural comparisons. Differences between rural populations mainly concern specific health problems and determinants, while notable variations on these are noted within rural areas. Some avenues for further research and public health policies in U.S are presented.

Table of Contents

a)Present scenario of Rural Health in the U.S6

1)Rural Health6

2)Rural Health services8

b)Importance of the Problem9

c)Research Question(s)9

d)Paper outline10

CHAPTER 2: HEALTH STATUS AND RISK11

a)Epidemiological factors:11

b)Health Risk Behavior12

1)Occupational Hazards13

2)Environmental Hazards13

3)Health-Related Behaviors14

CHAPTER 3: AREA OF IMPACT ON RURAL PEOPLE15

a)Health insurance coverage15

b)Medicare Medicaid Payment change16

c)Quality, Financing and Delivery Reform17

d)Healthcare work force17

e)Public Health18

f)Long-term care19

CHAPTER 4: HEALTH CARE ACCESS IN RURAL AREA21

a)Government21

1)Federally Qualified Health Care centers (FQHC)21

2)Federally Qualified Primary care services(FQPCS)22

b)Physician22

1)Defination22

2)Physician services that are RHC/FQHC23

3)Other services, i.e. Prescription, Telephone services24

CHAPTER 5: HEALTH CARE ACCESS25

1)Affordability25

2)Availability25

3)Quality of Care26

CHAPTER 6: AFFORDABLE CARE ACT (ACA)28

1)Measurement and transparency28

2)Payment and incentives29

3)Support and tools in ACA30

4)Workforce Improvement30

CHAPTER 7: OPPORTUNITY AND CHALLENGES IN RURAL HEALTH CARE IMPROVEMENT32

1)With Use of Performance Indicator32

2)With Use of Information of Technology33

CHAPTER 8: SUMMARY34

CHAPTER 9: RECOMMENDATIONS37

CHAPTER 10: CONCLUSION38

REFERENCES40

Chapter 1: Introduction

Present scenario of Rural Health in the U.S

Rural Health

What constitutes rural in healthcare depends on the definition being used for rurality, and that is sometimes dependent on the type of healthcare being delivered. There currently is no consensus definition of what rural is in the United States, either for health or for other policy domains. Since 1910, the U.S. Census Bureau has used a threshold of 2,500 people living in an incorporated place as its definition of rural; that definition remains in place today, but it is seldom used except for classification purposes in the census. A more widely used and recognized definition is the “metropolitan” designation process developed by the U.S. Office of Management and Budget (OMB), the White House office responsible for devising and submitting the president's annual budget proposal to Congress. The OMB classifies counties as metropolitan if they include a central city of at least 50,000 people or contain an urban cluster of that size or if they are closely tied to central metropolitan counties by commuting or economic trade patterns. The OMB originally identified only metropolitan counties but later designated core and other metro counties. In 2000, the nonmetropolitan counties with small urban centers were classified as “micropolitan.” The U.S. Department of Agriculture (USDA) has created several different classifications of nonmetropolitan counties (non-Core Based Statistical Areas, functional regions based around an urban center ...