Access and Issues of Equity in Remote/Rural Areas

Bull, C. Neil; Krout, John A.; Rathbone‐McCuan, Eloise; Shreffler, M. Jean

doi:10.1111/j.1748-0361.2001.tb00288.x

Cited by 75 publications

(52 citation statements)

References 4 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, studies suggest that rural norms and values, such as a sense of independence and hesitation to seek assistance, may result in foregoing or delaying medical attention. 44 Future studies should explore these potential explanations.…”

Section: Discussionmentioning

confidence: 99%

Rural-Urban Differences in Preventable Hospitalizations Among Community-Dwelling Veterans With Dementia

Thorpe

Houtven

Sleath

et al. 2010

The Journal of Rural Health

View full text Add to dashboard Cite

Context Alzheimer’s patients living in rural communities may face significant barriers to effective outpatient medical care. Purpose We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator of access to outpatient care, in community-dwelling veterans with dementia. Methods Medicare and VA inpatient claims for 1,186 United States veterans with dementia were linked to survey data from the 1998 National Longitudinal Caregiver Survey. ACSH were identified in inpatient claims over a one-year period following collection of independent variables. Urban Influence Codes were used to classify care-recipients into four categories of increasing county-level rurality: large metropolitan; small metropolitan; micropolitan; and non-core rural counties. We used the Andersen Behavioral Model of Health Services Use to identify veteran, caregiver, and community factors that may explain urban-rural differences in ACSH. Findings Thirteen percent of care-recipients had at least one ACSH. Likelihood of ACSH was greater for patients in non-core rural counties versus large metropolitan areas (22.6% versus 12.8%, unadjusted odds ratio [OR] = 1.99; p < .05). The addition of other Andersen behavioral model variables did not eliminate the disparity (adjusted OR = 1.97; p < .05). Conclusions We found that dementia patients living in the most rural counties were more likely to have an ACSH; this disparity was not explained by differences in caregiver, care-recipient, or community factors. Furthermore, the annual rate of ACSH was higher in community-dwelling dementia patients compared to previous reports on the general older adult population. Dementia patients in rural areas may face particular challenges in receiving timely, effective ambulatory care.

show abstract

Section: Discussionmentioning

confidence: 99%

Rural-Urban Differences in Preventable Hospitalizations Among Community-Dwelling Veterans With Dementia

Thorpe

Houtven

Sleath

et al. 2010

The Journal of Rural Health

View full text Add to dashboard Cite

show abstract

“…Such research would be relevant for countries such as Canada, Australia, and the United States where greater distances, of at least a 1-hour drive and sometimes exceeding a 5-hour drive, can exist between resource-dependent towns and regional centers (Bull, Krout, Rathbone-McCuan, & Shreffler, 2001;Mitchell, Robinson, McEvoy, & Gates, 2001). Some research in Canada, Australia, and Ireland has examined alternative transportation networks to link seniors with regionalized health care and shopping services (Halseth & Williams, 1999;Nutley, 2003).…”

Section: The Restructuring Of Resource Towns In Canadamentioning

confidence: 97%

Resolving Mobility Constraints Impeding Rural Seniors' Access to Regionalized Services

Ryser

Halseth

2012

Journal of Aging & Social Policy

View full text Add to dashboard Cite

“…In addition to disparities in education, several reported that in rural areas, more individuals live below the poverty line compared with urban areas, which could limit the ability of rural individuals to meet research-related demands, such as cost for transportation, diagnostic testing and medication, as well as the time required to participate in clinical trials [18, 19, 22, 23]. Further, two reports concluded that compared with urban residents, rural individuals are more likely to report reduced health statuses and suffer from chronic conditions that compromise their ability to participate clinical research studies [24, 32]. In some cases, competing priorities in caring for their own chronic conditions and those of family members, as well as busy farming and ranching schedules, precluded individuals from participation [19, 22, 29].…”

Section: Resultsmentioning

confidence: 99%

A Conceptual Framework for Barriers to the Recruitment and Retention of Rural CVD Participants in Behavior Intervention Trials

Young¹,

Montgomery²,

Barnason³

et al. 2015

JNHC

View full text Add to dashboard Cite

Background-Rural residents diagnosed with cardiovascular disease (CVD) or with CVDrelated risks are underrepresented in behavioral intervention trials based on an extensive review of published studies. The low participation rate of rural residents weakens both the internal and external validity of published studies. Moreover, compared to urban residents, limited research exists to describe the unique barriers that limit the participation of rural residents in behavioral intervention trials.Objective-The purpose of this review is to identify a conceptual framework (CF) underpinning common barriers faced by rural CVD patients to enroll in behavioral intervention trials.Methods-We conducted a literature review using several electronic databases to obtain a representative sample of research articles, synthesized the evidence, and developed a CF to explain the barriers that may affect the research participation rate of rural residents with CVD or related risks.Results-We found our evidence-based CF well explained the barriers for rural CVD patients to take part in behavioral intervention trials. Besides contextual factors (i.e. patient, community and research levels), other common factors impacting rural patients' intent to enroll are lack of awareness and understanding about behavioral trials, limited support from their healthcare providers and social circles, unfavorable attitudes, and the lack of opportunity to participating research. Conclusion and Implication of result-The findings demonstrate the evidence-based model consisting of interlinked multi-level factors may help our understanding of the barriers encountered by rural CVD patients participating interventions to promote behavioral change. The implication for researchers is that identifying and developing strategies to overcome the barriers precedes conducting studies in rural communities.

show abstract

Access and Issues of Equity in Remote/Rural Areas

Cited by 75 publications

References 4 publications

Rural-Urban Differences in Preventable Hospitalizations Among Community-Dwelling Veterans With Dementia

Rural-Urban Differences in Preventable Hospitalizations Among Community-Dwelling Veterans With Dementia

Resolving Mobility Constraints Impeding Rural Seniors' Access to Regionalized Services

A Conceptual Framework for Barriers to the Recruitment and Retention of Rural CVD Participants in Behavior Intervention Trials

Contact Info

Product

Resources

About