Palacios Hazel Velasco, Brant Kristina, Rhubart Danielle, Jackson Jorden
Department of Agricultural Economics, Sociology, and Education, College of Agricultural Sciences, Pennsylvania State University, University Park, Texas, USA.
Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, Texas, USA.
J Rural Health. 2025 Mar;41(2):e12896. doi: 10.1111/jrh.12896. Epub 2024 Nov 7.
This study investigates the experiences of one rural community in Central Pennsylvania following the closure of its singular pharmacy and primary health care facility. It aims to understand community members' responses and adaptations to declining health care accessibility and broader implications for rural health policy and practice.
Employing a qualitative case study design, researchers conducted 26 in-depth interviews from May to December 2022. Interviews were grounded in a phenomenological approach and focused on participants' perceptions of their community and experiences accessing health care. Data were analyzed thematically following a coding reliability approach.
The closure of the health care facilities resulted in significant social and economic impacts, particularly among vulnerable groups, such as older adults, people with disabilities, and working-class families. Participants reported increased reliance on their social support networks to access care, delays in seeking care due to the strain from longer travel distances, and loss of familiar and trusted care providers. We also found an over-reliance on local emergency medical services for routine care. Although the community demonstrated resilience through the use of social networks, some adaptations carried health risks, including delayed care and unmonitored use of alternative remedies.
This study highligths the need for health care policies that address the immediate loss of services and support the social networks and economic stability that rural communities rely on in the absence of local health care facilities. This research contributes insights for policymakers, health care providers, and community leaders working to support rural communities facing similar health care losses.
本研究调查了宾夕法尼亚州中部一个农村社区在其唯一的药房和初级卫生保健设施关闭后的经历。其旨在了解社区成员对医疗保健可及性下降的反应和适应情况，以及对农村卫生政策和实践的更广泛影响。
采用定性案例研究设计，研究人员在2022年5月至12月期间进行了26次深入访谈。访谈基于现象学方法，重点关注参与者对其社区的看法以及获得医疗保健的经历。数据采用编码可靠性方法进行主题分析。
医疗保健设施的关闭造成了重大的社会和经济影响，尤其是对弱势群体，如老年人、残疾人以及工人阶级家庭。参与者报告称，他们在获得医疗服务方面越来越依赖社会支持网络，由于长途跋涉带来的压力，寻求医疗服务出现延迟，并且失去了熟悉和信任的医疗服务提供者。我们还发现，社区在日常护理方面过度依赖当地的紧急医疗服务。尽管社区通过利用社会网络展现出了韧性，但一些适应措施带来了健康风险，包括延迟治疗和无监督地使用替代疗法。
本研究强调了医疗保健政策的必要性，这些政策应解决服务的立即丧失问题，并支持农村社区在缺乏当地医疗保健设施时所依赖的社会网络和经济稳定。这项研究为致力于支持面临类似医疗保健损失的农村社区的政策制定者、医疗保健提供者和社区领袖提供了见解。
