Department of Urology, Dow Division of Health Services Research, School of Medicine, University of Michigan, Ann Arbor, MI, USA
Department of Surgery, School of Medicine, University of Michigan, Ann Arbor, MI, USA
Rural Remote Health. 2023 May;23(2):7769. doi: 10.22605/RRH7769. Epub 2023 May 17.
Rural populations routinely rank poorly on common health indicators. While it is understood that rural residents face barriers to health care, the exact nature of these barriers remains unclear. To further define these barriers, a qualitative study of primary care physicians practicing in rural communities was performed.
Semistructured interviews were conducted with primary care physicians practicing in rural areas within western Pennsylvania, the third largest rural population within the USA, using purposively sampling. Data were then transcribed, coded, and analyzed by thematic analysis.
Three key themes emerged from the analysis addressing barriers to rural health care: (1) cost and insurance, (2) geographic dispersion, and (3) provider shortage and burnout. Providers mentioned strategies that they either employed or thought would be beneficial for their rural communities: (1) subsidize services, (2) establish mobile and satellite clinics (particularly for specialty care), (3) increase utilization of telehealth, (4) improve infrastructure for ancillary patient support (ie social work services), and (5) increase utilization of advanced practice providers.
There are numerous barriers to providing rural communities with quality health care. Barriers that are encountered are multidimensional. Patients are unable to obtain the care they need because of cost-related barriers. More providers need to be recruited to rural areas to combat the shortage and burnout. Advanced care-delivery methods such as telehealth, satellite clinics, or advanced practice providers can help bridge the gaps caused by geographic dispersion. Policy efforts should target all these aspects in order to appropriately address rural healthcare needs.
农村人口的常见健康指标通常排名较低。虽然人们知道农村居民面临着医疗保健障碍，但这些障碍的确切性质仍不清楚。为了进一步确定这些障碍，对在农村社区执业的初级保健医生进行了一项定性研究。
使用目的抽样法，对在美国第三大农村人口的宾夕法尼亚州西部农村地区执业的初级保健医生进行了半结构化访谈。然后对数据进行转录、编码和主题分析。
分析中出现了三个主题，涉及农村医疗保健的障碍：（1）成本和保险，（2）地理分散，（3）提供者短缺和倦怠。提供者提到了他们所采用或认为对农村社区有益的策略：（1）补贴服务，（2）建立移动和卫星诊所（特别是针对专科护理），（3）增加远程医疗的使用，（4）改善辅助患者支持的基础设施（即社会工作服务），（5）增加使用高级实践提供者。
为农村社区提供高质量医疗保健存在许多障碍。遇到的障碍是多方面的。由于与成本相关的障碍，患者无法获得所需的护理。需要向农村地区招募更多的提供者，以应对短缺和倦怠问题。远程医疗、卫星诊所或高级实践提供者等先进的护理方法可以帮助弥合地理分散造成的差距。政策努力应针对所有这些方面，以适当解决农村医疗保健需求。
