Hughes, A., Watanabe-Galloway, S., Schnell, P., & Soliman, A. (2015) studied the differences in colorectal screening between rural-urban in Nebraska. Their investigation into the reasons behind this gap indicated a few differences, some of which were not of the expected variety. The authors found that rural residents were more likely to believe that colorectal cancer cannot be prevented, and thus they did not feel screening was worthwhile. A higher percentage of rural residents also indicated that cost was a barrier, as well as things like perceived embarrassment, perceived unpleasantness were indicators found more frequently among rural residents. The study indicates that there are definitely some cultural factors that speak to the rural-urban divide. However, they also found that people with a personal doctor had a higher rate of receiving screenings. This indicates that physician density can also play a role – people without a doctor are more likely to not receive advice to get screenings, or referrals, and these factors can definitely result in a lower rate of screening and higher rate of morbidity.
An Icelandic study (Haraldsdottir, S., Gudmundsson, S., Thorgeirsson, G., Lund, S. H., & Valdimarsdottir, U. A., 2017) regarding cardiovascular disease arrived at similar conclusions. The authors found that rural areas had a higher prevalence of preventable risk factors. However, they also found that hospital discharges were more frequent in rural areas, and that this might have contributed to higher mortality rates. The underlying causal factors of higher discharge rates were not studied here, but the implication is that shorter hospital stays might be more associated with rural residents, especially if the hospital is not in their community, but may deprive them of the full range of testing that they would have received had their stay been longer.
Amponsah, W. A., Tabi, M. M., & Gibbison, G. A. (2015) looked at cardiovascular disease in rural Georgia. As was the case with the Icelandic study, they found that lifestyle factors contributed to the gap in health outcomes. Rural residents in their study generally had lower socioeconomic status, and lower socioeconomic status is associated with higher rates of cardiovascular disease. This adds to the body of evidence that health disparities between rural and urban residents are at least in part attributed to lifestyle differences.
One of the roles that physicians play is to provide medical advice and guidance for their patients. Bo Nielsen, J., Leppin, A., e Gyrd-Hansen, D., Ejg Jarbøl, D., Søndergaard, J., Veldt Larsen, P., & ... Larsen, P. V. (2017) conducted a study in Denmark to query potential gaps in preventative care as a reason for the rural-urban outcome divide. As in many of the other studies, socioeconomic factors were linked to lifestyle choices that in turn saw increased likelihood of cardiovascular disease. In their study, rural residents were more likely to smoke, have poor diets and abstain from exercise.
Campbell, D. T., Manns, B. J., Weaver, R. G., Hemmelgarn, B. R., King-Shier, K. M., & Sanmartin, C. (2017) conducted a study in Canada that was not specifically linked to the rural-urban question. They found, however, the correlation between lower socioeconomic status and higher rates of cardiovascular disease held in their study. They specifically cited that financial barriers to accessing medications and healthy food as reasons why poorer people faced higher rates of cardiovascular disease. This removes the rural-urban dynamic from the argument, but lends further support to the link between socioeconomic status and higher rates of cardiovascular disease.
In South Carolina, rural residents face further barriers, including several that are not directly linked to socioeconomic status. Some of the barriers identified for them include lack of health insurance, lack of knowledge, misperceptions and fear, and limited accessibility as reasons why rural South Carolinians do not participate in clinical trials (Kim, S., Tanner, A., Friedman, D., Foster, C., & Bergeron, C. (2014). A fairly reasonable argument can be made that these factors could easily apply to other forms of health care as well.
Where other studies looked at lifestyle factors, Allenby, A., Kinsman, L., Tham, R., Symons, J., Jones, M., & Campbell, S. (2016) took a different approach and looked at the quality of care in rural communities, to compare it to the quality of care in urban communities. There is a clear association between targeted preventative activities and practice factors....
Abbott, L., Williams, C., Slate, E., & Gropper, S. (2018). Promoting Heart Health Among Rural African Americans. Journal Of Cardiovascular Nursing, 33(1), E8-E14. doi:10.1097/JCN.0000000000000410
Allenby, A., Kinsman, L., Tham, R., Symons, J., Jones, M., & Campbell, S. (2016). The quality of cardiovascular disease prevention in rural primary care. Australian Journal Of Rural Health, 24(2), 92-98. doi:10.1111/ajr.12224
Amponsah, W. A., Tabi, M. M., & Gibbison, G. A. (2015). Health Disparities in Cardiovascular Disease and High Blood Pressure among Adults in Rural Underserved Communities. Online Journal Of Rural Nursing & Health Care, 15(1), 185-208. doi:10.14574/ojrnhc.v15i1.351
Bo Nielsen, J., Leppin, A., e Gyrd-Hansen, D., Ejg Jarbøl, D., Søndergaard, J., Veldt Larsen, P., & ... Larsen, P. V. ( 2017). Barriers to lifestyle changes for prevention of cardiovascular disease - a survey among 40-60-year old Danes. BMC Cardiovascular Disorders, 171-8. doi:10.1186/s12872-017-0677
Campbell, D. T., Manns, B. J., Weaver, R. G., Hemmelgarn, B. R., King-Shier, K. M., & Sanmartin, C. (2017). Financial barriers and adverse clinical outcomes among patients with cardiovascular-related chronic diseases: a cohort study. BMC Medicine, 151-13. doi:10.1186/s12916-017-0788-6
Choo, W. K., McGeary, K., Farman, C., Greyling, A., Cross, S. J., & Leslie, S. J. (2014). Utilisation of a direct access echocardiography service by general practitioners in a remote and rural area - distance and rurality are not barriers to referral. Rural & Remote Health, 14(4), 1-6.
Haraldsdottir, S., Gudmundsson, S., Thorgeirsson, G., Lund, S. H., & Valdimarsdottir, U. A.(2017). Regional differences in mortality, hospital discharges and primary care contacts for cardiovascular disease Scandinavian Journal Of Public Health, 45(3), 260-268. doi:10.1177/1403494816685341
Harrington RA and Heidenreich PA. Team-Based Care and Quality: A Move Toward Evidence-Based Policy. J Am Coll Cardiol. 2015;66:1813-5.
Hughes, A., Watanabe-Galloway, S., Schnell, P., & Soliman, A. (2015). Rural-Urban Differences in Colorectal Cancer Screening Barriers in Nebraska. Journal Of Community Health, 40(6), 1065-1074. doi:10.1007/s10900-015-0032-2
Figure 1 portrays the state of Maryland, the location for the focus of this DRP. Figure 1: Map of Maryland, the State (Google Maps, 2009) 1.3 Study Structure Organization of the Study The following five chapters constitute the body of Chapter I: Introduction Chapter II: Review of the Literature Chapter III: Methods and Results Chapter IV: Chapter V: Conclusions, Recommendations, and Implications Chapter I: Introduction During Chapter I, the researcher presents this study's focus, as it relates to the
HEALTHCARE PROPOSAL Healthcare Proposal Annotated BibliographyAbelsen, B., Strasser, R., Heaney, D., Berggren, P., Sigurosson, S., Brandstorp, H., Wakegijig, J., Forsling, N., Moody-Corbett, P., Akearok, G.H., Mason, A., Savage, C. & Nicoll, P. (2020). Plan, recruit, retain: A framework for local healthcare organizations to achieve a stable remote rural workforce. Human Resources for Health, 18. https://doi.org/10.1186/s12960-020-00502-xThe article discusses the effectiveness of The Framework for Remote Rural Workforce Stability designed to fortify
Therefore in the economic sense many institutions have been viewed to lay back. Knowledge and Expertise in Telemedicine Another challenge has to do with the limited knowledge and expertise in telemedicine as well as the need for enhanced and modified telemedicine systems. In this sense, little knowledge currently exists among medical practitioners on how to effectively and practically use various forms of telemedicine. This knowledge gap on insight into telemedicine, in
1903). The management goal for HCH is to improve the effectiveness of health care delivery to the homeless and indigent of Milwaukee in close partnership with the community. In this regard, the management of the HCH community health center requires careful and timely coordination between the community health care specialists, including family practice physicians and advanced practice nurses, who provide accessible primary care preventive health services. There are also management
The issue of grey and black markets often arose as a result of the shortages of experienced health care personnel. The system could not adapt to a flexible environment as it was led by rigid official procedures and the mentality of the people who controlled it was commanding, their vision short-sighted and hardly beneficial in such a situation (Barr and Mark, 1996). The breaking up of Soviet Union which brought
what drives/motivates providers. In a nutshell, these authors assert that any healthcare system built on market principles is doomed to eventual crisis as payers (meaning patients by and large, whether directly or through government taxation) attempt to receive adequate care while reducing the flow of dollars to providers while providers attempt to increase the flow of dollars for the same or lower levels of care (Harrington & Estes, 2008).
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