ACCESS TO HEALTH CARE

Access to quality health care services is critical to good health, yet rural residents face barriers that can have significant consequences including:

·         Delays in receiving appropriate care

·         Inability to access preventive services

·         Financial burdens

·         Preventable hospitalizations

·         Inappropriate use of the emergency services

These concerns were echoed by county residents in the Community Needs Assessment Survey and focus groups. Concerns most cited included the high cost of health care, inadequate or no insurance coverage, and lack of available services or appropriate providers.

One of the issues examined by members of the Access to Care Workgroup questioned how county residents find information about local health care services and providers. Studies have shown that improving access to information and communication technologies may help reduce health disparities through their potential for promoting health, preventing disease, and supporting clinical care. (3) What the Work Group discovered was that the county lacked a centralized resource with current and comprehensive information on local services and providers.  

As a result, they recommended the development of a health information center that would be staffed to provide phone and walk-in support, ensuring service for all population groups.  The center would also coordinate an online resource directory available 24-hours a day to connect residents with needed services and providers. 

The group also explored the effectiveness of community outreach programs in rural settings and found several promising models which may serve to help vulnerable populations gain access to care. These included expanding the role of emergency medical services (EMS) personnel as a crucial link in the chain of care; and improving outreach through the employment of community health workers. The use of community health workers to overcome ethnic and racial disparities in healthcare has been well documented, including more than a decade ago by the Institute of Medicine.(4) The work group members agreed to investigate both models more fully before finalizing recommendations.   

The group also discovered local efforts were underway to increase awareness and use of advance care planning in patient care plans. Advance care planning is defined as making decisions about the care a patient would want to receive if they were unable to speak for themselves. (5) This presented an opportunity to build on existing community and stakeholder interests to increase individual engagement in proactive health care planning.