Hicks L L
Program in Health Services Management, University of Missouri, Columbia 65211.
J Rural Health. 1990 Oct;6(4):485-505. doi: 10.1111/j.1748-0361.1990.tb00684.x.
The 1980s saw a retrenchment of the ideology that government intervention could solve the problems of inadequate access to health services in rural areas. Increased emphasis was placed on an ideology that promoted deregulation and competitive market solutions. During the 1980s, the gap in the availability of physicians in metropolitan versus nonmetropolitan areas widened. Also during that time period, the gap between metropolitan and nonmetropolitan populations' utilization of physician services widened. In addition, many indicators of the health status of nonmetropolitan residents versus metropolitan residents worsened during the 1980s. As we enter the 1990s, concern about equitable access to needed health care services and for the vulnerability and fragility of rural health systems has resurfaced. A number of national policies and a research agenda to improve accessibility and availability of health services in rural areas are being considered.
20世纪80年代，那种认为政府干预能够解决农村地区医疗服务获取不足问题的意识形态出现了倒退。人们愈发强调一种主张放松管制和采用竞争性市场解决方案的意识形态。在20世纪80年代，大城市与非大城市地区医生可及性的差距扩大了。同样在那个时期，大城市和非大城市人口对医生服务的利用率差距也扩大了。此外，在20世纪80年代，非大城市居民与大城市居民健康状况的许多指标都恶化了。随着我们进入20世纪90年代，对公平获取所需医疗服务以及农村卫生系统的脆弱性和易损性的担忧再度浮现。一些旨在改善农村地区医疗服务可及性和可得性的国家政策及一项研究议程正在被考虑之中。
