Center for Community Health Development, Texas A&M School of Rural Public Health, College Station, TX 77843-1266, USA.
J Am Board Fam Med. 2013 May-Jun;26(3):246-53. doi: 10.3122/jabfm.2013.03.120242.
Compared with their urban counterparts, rural populations face substantial disparities in terms of health care and health outcomes, particularly with regard to access to health services. To address ongoing inequities, community perspectives are increasingly important in identifying health issues and developing local solutions that are effective and sustainable. This article has been developed by both academic and community representatives and presents a brief case study of the evolution of a regional community of solution (COS) servicing a 7-county region called the Brazos Valley, Texas. The regional COS gave rise to multiple, more localized COSs that implemented similar strategies designed to address access to care within rural communities. The regional COS, known as the Brazos Valley Health Partnership, was a result of a 2002 health status assessment that revealed that rural residents face poorer access to health services and their care is often fragmented. Their localized strategy, called a health resource center, was created as a "one-stop shop" where multiple health and social service providers could be housed to deliver services to rural residents. Initially piloted in Madison County, the resource center model was expanded into Burleson, Grimes, and Leon Counties because of community buy-in at each of these sites. The resource center concept allowed service providers, who previously were able to offer services only in more populous areas, to expand into the rural communities because of reduced overhead costs. The services provided at the health resource centers include transportation, information and referral, and case management along with others, depending on the location. To ensure successful ongoing operations and future planning of the resource centers, local oversight bodies known as health resource commissions were organized within each of the rural communities to represent local COSs. Through collaboration with local entities, these partnerships have been successful in continuing to expand services and initiating health improvements within their rural communities.
与城市人口相比，农村人口在医疗保健和健康结果方面存在着巨大的差异，特别是在获得卫生服务方面。为了解决持续存在的不平等问题，社区视角在确定健康问题和制定有效和可持续的地方解决方案方面越来越重要。本文由学术和社区代表共同撰写，简要介绍了一个区域性社区解决方案（COS）的演变过程，该解决方案服务于一个名为德克萨斯州布拉佐斯河谷的 7 个县地区。这个区域性的 COS 产生了多个更加本地化的 COS，这些 COS 实施了类似的策略，旨在解决农村社区的医疗服务可及性问题。这个区域性的 COS 被称为布拉佐斯河谷健康伙伴关系，它是 2002 年健康状况评估的结果，该评估显示农村居民获得医疗服务的机会较差，他们的医疗服务往往是分散的。他们的本地化策略，称为健康资源中心，是作为一个“一站式服务”创建的，多个卫生和社会服务提供者可以在那里提供服务，为农村居民提供服务。该资源中心模式最初在麦迪逊县试行，由于每个县的社区参与，该模式扩展到伯利森、格里姆斯和莱昂县。由于运营成本降低，资源中心的概念使以前只能在人口较多地区提供服务的服务提供者能够扩展到农村社区。健康资源中心提供的服务包括交通、信息和转介以及个案管理，具体取决于地点。为了确保资源中心的成功持续运营和未来规划，在每个农村社区都成立了名为健康资源委员会的地方监督机构，以代表地方 COS。通过与当地实体的合作，这些伙伴关系在继续扩大服务和改善农村社区的健康状况方面取得了成功。
