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An Evaluation of Rural Health Care Research

Author

Listed:
  • Robert Kane

    (Rand Corporation and the University of California at Los Angeles)

  • Marilyn Dean

    (Rand Corporation)

  • Marian Solomon

    (U.S. Department of Health, Education and Welfare)

Abstract

This article reviews the state of the art of rural health research and evaluation with par ticular emphasis on the questions of access, health personnel, and financing. The current state of knowledge both in the published and in the unpublished literature in each area is summarized and a series of unresolved issues is proposed. A strategy for further research to include the various types of rural health care programs is described. Major findings suggest that, although rural populations do have somewhat less access to care than do urban populations, our ability to quantify precisely the extent and importance of this discrepancy is underdeveloped. Despite a substantial investment in a variety of rural health care programs there is inadequate information as to their effectiveness. Programs designed to increase the supply of health personnel to rural areas have met with mixed success. Sites staffed by National Health Service Corps personnel show consistently lower productivity than do sites under other sponsorship. Nonphysician personnel (physician assistants and nurse practitioners) offer apromising source of primary carefor rural areas; recent legislation that reimburses such care should increase their utilization. A persistent problem is the expectation (often a mandate) incorporated into many rural health care demonstration efforts that the programs become financially self-sufficient in a finite period of time. Self-sufficiency is a function of utilization, productivity, and the ability to recover charges for services. In many instances stringent enforcement of the self-suf ficiency requirement may mean those those who need the services most will be least likely to receive them.

Suggested Citation

  • Robert Kane & Marilyn Dean & Marian Solomon, 1979. "An Evaluation of Rural Health Care Research," Evaluation Review, , vol. 3(2), pages 139-189, May.
    • Handle: RePEc:sae:evarev:v:3:y:1979:i:2:p:139-189
    DOI: 10.1177/0193841X7900300201
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    References listed on IDEAS

    as
    1. Cooper, J.K. & Heald, K. & Samuels, M., 1977. "Affecting the supply of rural physicians," American Journal of Public Health, American Public Health Association, vol. 67(8), pages 756-759.
    2. Katz, H.P. & Pozen, J. & Mushlin, A.I., 1978. "Quality assessment of a telephone care system utilizing non-physician personnel," American Journal of Public Health, American Public Health Association, vol. 68(1), pages 31-38.
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    4. Sullivan, J.A. & Dachelet, C.Z. & Sultz, H.A. & Henry, M., 1978. "The rural nurse practitioner: a challenge and a response," American Journal of Public Health, American Public Health Association, vol. 68(10), pages 972-976.
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    6. Murphy Jr., R.L. & Bird, K.T., 1974. "Telediagnosis: a new community health resource. Observations on the feasibility of telediagnosis based on 1000 patient transactions," American Journal of Public Health, American Public Health Association, vol. 64(2), pages 113-119.
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    8. Jeffers, J.R. & Bognanno, M.F. & Bartlett, J.C., 1971. "On the demand versus need for medical services and the concept of "shortage"," American Journal of Public Health, American Public Health Association, vol. 61(1), pages 46-63.
    9. Simborg, D.W. & Starfield, B.H. & Horn, S.D., 1978. "Physicians and non-physician health practitioners: The characteristics of their practices and their relationships," American Journal of Public Health, American Public Health Association, vol. 68(1), pages 44-48.
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