The Experts below are selected from a list of 91932 Experts worldwide ranked by ideXlab platform
Thomas A Arcury - One of the best experts on this subject based on the ideXlab platform.
-
the effects of geography and spatial behavior on Health Care utilization among the residents of a Rural region
Health Services Research, 2005Co-Authors: Thomas A Arcury, Wilbert M Gesler, John S Preisser, Jill E Sherman, John Spencer, Jamie PerinAbstract:The goal of this analysis is to determine the importance of geographic and spatial behavior factors in the Health Care utilization of the residents of Rural communities. These geographic factors are part of a general conceptual framework of Rural Health Care utilization. The Health and Health Care of Rural Americans are complex. Rural Americans are disadvantaged compared with their urban counterparts in several important ways that affect their Health: they are disproportionately poorer, proportionately fewer are of working age, and they have less education (Ricketts 1999). The Rural U.S. has 20 percent of the national population, but less than 11 percent of its physicians. Rural versus urban residents are more often uninsured (18.7 versus 16.3 percent), more likely to report being in fair or poor Health, have restricted activity, and lower levels of access to a regular primary Care provider (Ricketts 1999). A major problem that Rural dwellers face is access to Care (Ricketts and Savitz 1994; MediCare Payment Advisory Commission 2001). Although access can be measured in many ways, geographic access is of primary concern in many Rural areas. People who live in isolated places, relatively far from metropolitan areas or urban centers, often find it very difficult to contact Health Care personnel or facilities. In comparison with urban dwellers, Rural residents have to travel farther to Care and face other problems such as poor quality roads and lack of public transportation. These problems are well known and yet their solution eludes the efforts of the U.S. Congress, state legislatures, and regional governments (Ricketts 1999).
-
access to transportation and Health Care utilization in a Rural region
Journal of Rural Health, 2005Co-Authors: Thomas A Arcury, Wilbert M Gesler, John S Preisser, James M. PowersAbstract:ABSTRACT: Context: Access to transportation to transverse the large distances between residences and Health services in Rural settings is a necessity. However, little research has examined directly access to transportation in analyses of Rural Health Care utilization. Purpose: This analysis addresses the association of transportation and Health Care utilization in a Rural region. Methods: Using survey data from a sample of 1,059 households located in 12 western North Carolina counties, this analysis tests the relationship of different transportation measures to Health Care utilization while adjusting for the effects of personal characteristics, Health characteristics, and distance. Findings: Those who had a driver's license had 2.29 times more Health Care visits for chronic Care and 1.92 times more visits for regular checkup Care than those who did not. Respondents who had family or friends who could provide transportation had 1.58 times more visits for chronic Care than those who did not. While not significant in the multivariate analysis, the small number who used public transportation had 4 more chronic Care visits per year than those who did not. Age and lower Health status were also associated with increased Health Care visits. The transportation variables that were significantly associated with Health Care visits suggest that the underlying conceptual frameworks, the Health Behavior Model and Hagerstrand's time geography, are useful for understanding transportation behavior. Conclusions: Further research must address the transportation behavior related to Health Care and the factors that influence this behavior. This information will inform policy alternatives to address geographic barriers to Health Care in Rural communities.
Jamie Perin - One of the best experts on this subject based on the ideXlab platform.
-
the effects of geography and spatial behavior on Health Care utilization among the residents of a Rural region
Health Services Research, 2005Co-Authors: Thomas A Arcury, Wilbert M Gesler, John S Preisser, Jill E Sherman, John Spencer, Jamie PerinAbstract:The goal of this analysis is to determine the importance of geographic and spatial behavior factors in the Health Care utilization of the residents of Rural communities. These geographic factors are part of a general conceptual framework of Rural Health Care utilization. The Health and Health Care of Rural Americans are complex. Rural Americans are disadvantaged compared with their urban counterparts in several important ways that affect their Health: they are disproportionately poorer, proportionately fewer are of working age, and they have less education (Ricketts 1999). The Rural U.S. has 20 percent of the national population, but less than 11 percent of its physicians. Rural versus urban residents are more often uninsured (18.7 versus 16.3 percent), more likely to report being in fair or poor Health, have restricted activity, and lower levels of access to a regular primary Care provider (Ricketts 1999). A major problem that Rural dwellers face is access to Care (Ricketts and Savitz 1994; MediCare Payment Advisory Commission 2001). Although access can be measured in many ways, geographic access is of primary concern in many Rural areas. People who live in isolated places, relatively far from metropolitan areas or urban centers, often find it very difficult to contact Health Care personnel or facilities. In comparison with urban dwellers, Rural residents have to travel farther to Care and face other problems such as poor quality roads and lack of public transportation. These problems are well known and yet their solution eludes the efforts of the U.S. Congress, state legislatures, and regional governments (Ricketts 1999).
Brad D Wright - One of the best experts on this subject based on the ideXlab platform.
-
Care in the country a historical case study of long term sustainability in 4 Rural Health centers
American Journal of Public Health, 2009Co-Authors: Brad D WrightAbstract:From 1978 to 1983, researchers at the University of North Carolina conducted a National Evaluation of Rural Primary Care Programs. Thirty years later, many of the programs they studied have closed, but the challenges of providing Rural Health Care have persisted. I explored the histories of 4 surviving Rural primary Care programs and identified factors that contributed to their sustainability. These included physician advocates, innovative practices, organizational flexibility, and community integration. As Rural Health programs look ahead, identifying future generations of physician advocates is a crucial next step in developing the Rural primary Care workforce. It is also important for these programs to find ways to cope with high rates of staff turnover.
Andy Haines - One of the best experts on this subject based on the ideXlab platform.
-
the effectiveness of an integrated Rural Health Care intervention during the covid 19 pandemic response in siaya kenya a prospective quasi experimental study
Social Science Research Network, 2021Co-Authors: N Kaseje, K Oruenjo, D Kaseje, M Ranganathan, Marcel Tanner, Andy HainesAbstract:Background: Globally, the COVID-19 pandemic has had broad consequences on Health outcomes with significant morbidity and mortality. Rural Health systems face more challenges in the availability of a workforce, adequate infrastructure and equipment. We completed a baseline assessment of the Health system in Siaya at the beginning stages of the COVID-19 pandemic and designed an integrated intervention to maximize the prevention of COVID-19 cases and optimize case management at community and Health facility levels. Methods: In partnership with the Ministry of Health (MOH), we trained Health Care workers in COVID-19 infection prevention, control, and case management at community and Health facility levels. We strengthened the diagnostic and monitoring capacity of HealthCare workers with thermometers and pulse oximeters, and we trained clinicians in basic critical Care. In addition, we addressed leadership skills and psychological first aid. Youth were included during implementation to promote the uptake of digital tools by Health Care workers. Primary outcome measures were the total number of confirmed COVID-19 cases and the total number of COVID-19 related deaths in Siaya. Secondary outcome measures were related to hand hygiene practices and use of essential Health services; specifically, the incidence of diarrheal diseases and respiratory infections not related to COVID-19, and the number of facility based deliveries. Findings: The incidence of confirmed COVID-19 cases was low compared to neighboring counties (with risk reduction ratios up to 7.8, CI 6.85-8.89). The total number of COVID-19 cases was 266 and the total number of COVID-19 related deaths was 7 at the time of the analysis in November 2020. The incidences of diarrheal diseases and respiratory infections (URTIs) not related to COVID-19 were lower in 2020 compared to 2019 and use of essential maternal Health services was maintained during the COVID-19 response: specifically, the mean number of diarrheal cases was 3’033 in 2020 and 4’795 in 2019 (p=0.001); the mean number of URTIs not related to COVID-19 was 19’683 in 2020 and 27’567 in 2019 (p=0.015); and the mean number of facility based deliveries was 2’402 in 2020 and 2’322 in 2019 (p=0.2). Interpretation: An integrated and comprehensive intervention with capacity building at community and Health facility levels results in the reduction of COVID-19 infections, and the reduction in the number of diarrheal and non COVID-19 related respiratory infections. Furthermore, the intervention resulted in the maintained use of maternal Health services during the COVID-19 response. Trial Registration: Clinicaltrials.gov NCT04501458 Funding Statement: Wellcome Trust Declaration of Interests: None to declare. Ethics Approval Statement: Ethical review approvals received from the University of Nairobi Ethics Review Committee and Jaramogi Oginga Odinga Teaching and Referral Hospital Ethics Review Committee (approval number IERC/JOOTR/219/20)
Wilbert M Gesler - One of the best experts on this subject based on the ideXlab platform.
-
the effects of geography and spatial behavior on Health Care utilization among the residents of a Rural region
Health Services Research, 2005Co-Authors: Thomas A Arcury, Wilbert M Gesler, John S Preisser, Jill E Sherman, John Spencer, Jamie PerinAbstract:The goal of this analysis is to determine the importance of geographic and spatial behavior factors in the Health Care utilization of the residents of Rural communities. These geographic factors are part of a general conceptual framework of Rural Health Care utilization. The Health and Health Care of Rural Americans are complex. Rural Americans are disadvantaged compared with their urban counterparts in several important ways that affect their Health: they are disproportionately poorer, proportionately fewer are of working age, and they have less education (Ricketts 1999). The Rural U.S. has 20 percent of the national population, but less than 11 percent of its physicians. Rural versus urban residents are more often uninsured (18.7 versus 16.3 percent), more likely to report being in fair or poor Health, have restricted activity, and lower levels of access to a regular primary Care provider (Ricketts 1999). A major problem that Rural dwellers face is access to Care (Ricketts and Savitz 1994; MediCare Payment Advisory Commission 2001). Although access can be measured in many ways, geographic access is of primary concern in many Rural areas. People who live in isolated places, relatively far from metropolitan areas or urban centers, often find it very difficult to contact Health Care personnel or facilities. In comparison with urban dwellers, Rural residents have to travel farther to Care and face other problems such as poor quality roads and lack of public transportation. These problems are well known and yet their solution eludes the efforts of the U.S. Congress, state legislatures, and regional governments (Ricketts 1999).
-
access to transportation and Health Care utilization in a Rural region
Journal of Rural Health, 2005Co-Authors: Thomas A Arcury, Wilbert M Gesler, John S Preisser, James M. PowersAbstract:ABSTRACT: Context: Access to transportation to transverse the large distances between residences and Health services in Rural settings is a necessity. However, little research has examined directly access to transportation in analyses of Rural Health Care utilization. Purpose: This analysis addresses the association of transportation and Health Care utilization in a Rural region. Methods: Using survey data from a sample of 1,059 households located in 12 western North Carolina counties, this analysis tests the relationship of different transportation measures to Health Care utilization while adjusting for the effects of personal characteristics, Health characteristics, and distance. Findings: Those who had a driver's license had 2.29 times more Health Care visits for chronic Care and 1.92 times more visits for regular checkup Care than those who did not. Respondents who had family or friends who could provide transportation had 1.58 times more visits for chronic Care than those who did not. While not significant in the multivariate analysis, the small number who used public transportation had 4 more chronic Care visits per year than those who did not. Age and lower Health status were also associated with increased Health Care visits. The transportation variables that were significantly associated with Health Care visits suggest that the underlying conceptual frameworks, the Health Behavior Model and Hagerstrand's time geography, are useful for understanding transportation behavior. Conclusions: Further research must address the transportation behavior related to Health Care and the factors that influence this behavior. This information will inform policy alternatives to address geographic barriers to Health Care in Rural communities.
