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Abstract

The purpose of this study was to determine the accessibility and perceived value of health services in five selected rural communities in South Fulton County, Illinois. The Health Services Accessibility and Value Scale (HSAVS) component of the larger Fulton County Health Care Survey was used in the investigation. The 12 items comprising the HSAVS surveyed participant perceptions relative to medical, dental, nursing, and public health department services available to them as rural residents. The HSAVS was completed by 1709 subjects. The reliability of the HSAVS was assessed by computing coefficient alpha. The scale had acceptable internal consistency reliability (alpha = .7884). To examine the construct validity of the scale, a principle component factor analysis was completed. This analysis resulted in a four factor solution which accounted for 66.6% of the cumulative total variance. Item means were calculated and were used to rank the HSAVS statements. Emergency and primary medical services were valued the most by the survey participants. Relatively high in importance to the rural residents surveyed were access to pharmacy, eye care, dental care, and immunization services. Availability of home health care, transportation to and from health care facilities, and access to mental health services were considered to be of lesser value to persons living in the rural area studied. Of least importance were alcohol and other drug counseling services, prenatal care/well baby services, and family planning services. HSAVS total scores and individual statements were also analyzed by sex, age, place of residence, and income and the results were reported.

Does “Rural” Always Mean the Same? Macrosocial Determinants of Rural Populations’ Health in Poland

“…Moreover, villagers have usually worse access to health care benefits [41,42]. Village residents rarely benefit from regular doctor visits [43,44] including preventive services [45] and tend to have weaker access to emergency services [46,47], which are usually located in urban areas. These differences in SDH contribute to health inequalities expressed by dissimilar life expectancies or healthy life expectancies [33].…”

Hospitals’ Financial Health in Rural and Urban Areas in Poland: Does It Ensure Sustainability?

“…According to the economic pillar of the traditional definition of the sustainable development, all hospitals operate using valuable and scarce resources and they have faced significant changes over recent decades [36]. Those changes of economic environment resulted in many countries in massive closures of rural hospitals due to their poor financial condition [37][38][39], so rural hospitals must adapt to reach the level of sustainability [31].…”

Social inequalities – theoretical considerations from an interdisciplinary perspective

“…The problems of inequalities in access to health care resulting from the place of residence in the urban-rural system are confirmed by scientific studies (Casey et al, 2001;Michalski, 2002;Bennett et al, 2012). Rural residents are less likely to visit doctors regularly (Arcury et al, 2005), including preventive examinations (Valet et al, 2009), and usually have less access to emergency services (Watts et al, 1999, Fan et al, 2011 which are more often located in urban areas (Ucieklak-Jeż, Bem, 2017). Numerous measurements carried out for rural areas in Poland indicate differentiated access to health care in rural areas.…”