Biology – Physiology WRITING ASSIGNMENT #5 FOR CAPSTONE: Discussion and Conclusion 5-9 pages (minimum of five complete pages of text)

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Discussion- Chapter 5 INSTRUCTIONS

Using the attached Chapter 5 – CAPSTONE EXAMPLE, conclude your study by providing a thorough discussion of key findings, as well as any recommendations for further research MINIMUM OF 5 PAGES. In this section of your study, you will include the following information:

** I WILL ATTACHED THE COMPLETED CHAPTERS, 1-4 FOR YOUR REVIEW AND GUIDEANCE TO COMPLETE THE DISCUSSION SECTION OF THIS CAPSTONE.

· Introduction (this introduction forms the transition, not an introduction to the study itself.  State the purpose of the section and then present the following sub-sections)

· Explain how your results answer or do not answer your research question

· Provide an explanation of the implications of your findings for public health professionals to use in their professional practice of public health services

· Provide an explanation of recommendations for future public health studies (be as specific as possible). Recommendations for Future Study (researchers can discuss as many as four categories of recommendations for further studies. Each category reflects back on one of the previous sub-sections; the three most common categories of recommendations include those: [1] developed directly from the data; [2] derived from methodological, research design or other limitations of the study; [3] to investigate issues not supported by the data but relevant to the problem being studied)

· Conclusion: Write a one paragraph summary of the findings of your study

Remember to cite/reference all outside works in proper APA style (7th edition).

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A SYSTEMATIC REVIEW OF THE EFFECTIVENESS OF TELEHEALTH/TELEMEDICINE

IN IMPROVING ACCESS TO CARE AND PATIENT SATISFACTION

Student Name

Capstone Project

In partial fulfillment of the degree Master of Public Health

National University

End of Course Date

I accept this capstone project on behalf of the Community Health Department, School of Health and Human Services, National University. Below the faculty who taught the capstone course, and the MPH Program Director will sign.

__________________________________________ ___________

Faculty/Professor of Capstone Date

Brandon Eggleston PhD

__________________________________________ ___________

MPH Program Director Date

Tyler Smith PhD

iii

CHAPTER 5. CONCLUSIONS AND RECOMMENDATION

Introduction

This chapter provides the implications for the research hypothesis: Telehealth or Telemedicine has improved access to care and increased patient satisfaction in various health care services before, during, and maybe after COVID 19 Pandemic.

The systematic review consisted of 50 articles that acknowledged a number of evidence that telehealth and telemedicine contributed to the expansion of access to healthcare in various locations and health services. Additionally, telehealth and telemedicine elevated patients' satisfaction in many aspects of healthcare. In rural health areas, telehealth can assist healthcare systems, organizations, and providers expand access to and improving healthcare quality. The use of telehealth in rural areas as a healthcare delivery avenue can reduce or minimize challenges and burdens patients encounter, such as transportation issues related to travel for specialty care (Fortney et al., 2013). Hence, telehealth can also improve monitoring, timeliness, and communications within the healthcare system.

Telehealth became a more prominent platform for providing healthcare during the COVID -19 pandemic when patients and providers sought to decrease in-person contact for routine visits. The implementation and continued expansion of telehealth services assist various healthcare organizations in delivering care during the COVID-19 global pandemic.

The study conducted by Bate et al. (2021) in Melbourne, Australia, revealed an excellent overall acceptance, satisfaction, and willingness for patients, parents, and clinicians to use telehealth in the future. The authors then added that as more and more people are exposed to telemedicine and the rapid cyclical disruption of COVID‐19 eventually plateaus, telehealth should be looked at for further mass expansion in the digital era (Bate et al., 2021).

According to Demeke et al. (2021), while the resumption of in-person health care visits is anticipated when COVID – 19 pandemic subsides, telehealth will still be a critical factor in improving access to health care, especially among populations with limited access to care and enhancing the U.S. health care system's capacity to continue in future pandemics. For example, funded health centers have played a critical role as primary care providers by providing testing, treatment, and preventive care, including vaccination. Sustaining expanded use of telehealth visits in health centers during and after the pandemic might require continuation of existing flexibilities provided under Centers for Medicare & Medicaid Services telehealth reimbursement policies and local level considerations of additional support and resources (Demeke et al., 2021).

Sundstrom et al. (2019) conducted a study about the role of telehealth in providing access to women needing contraceptives in Rural South Carolina. Telehealth paved the way for health communicators to inform rural women of their choices in contraceptive methods, implementing effective campaigns and interventions to decrease unplanned pregnancy through improved access. They found out that telehealth initiatives address barriers to contraceptive entry in rural locations. Furthermore, participants discussed the advantages of telehealth, such as reduced travel distances and saving costs such as gas and transportation to access contraceptive services. These findings provide theoretical and practical opportunities to guide telehealth interventions and health communication campaigns to increase contraceptive uptake and decrease unintended pregnancies among women living in rural areas (Sundstrom et al., 2019).

To show that telehealth improves patient satisfaction, a study conducted by Wilkinson et al. (2016) proves high patient satisfaction with telehealth use in patients with Parkinson's disease. The authors stated that telehealth showed similar results to clinical outcomes. It was found in the research that greater satisfaction for the telehealth modality was found in assessments of convenience and accessibility/distance. Although certain aspects of the neurologic examination cannot be completed remotely (e.g., pull test and muscle tone assessment), most movement disorder–related exams are conducive to an audiovisual approach using the modified version of test models (Wilkinson et al., 2016). In conclusion, researchers stated that as the need for Parkinson's disease subspecialty care increases, innovative patient-centered solutions to overcoming barriers to access, such as video telehealth, will be invaluable to patients and provide high patient satisfaction.

A study by Cho et al. (2021) stated that cardiology patients reported overall satisfaction with telehealth during the COVID-19 pandemic. The research identified factors associated with patient convenience, gender, younger age, and non-white ethnicity correlated with greater satisfaction. The authors then stated that further research into telehealth's impact on patient satisfaction, safety, and clinical outcome is needed.

Waqar-Cowles et al. (2021) identified that there are encouraging signs that telehealth may be a viable method to deliver pediatric rheumatology care in the future. The research explained that most patients and caregivers reported positive experiences across all telehealth assessment sub-scales. Furthermore, patients and families familiar with telehealthcare were more likely to consider telehealth equal or preferable to in-person visits. Acceptability may increase with greater exposure to video visits and application in more targeted cases and when pediatric rheumatology providers have more familiarity with telehealth delivery and identify more optimal use cases (Waqar-Cowles et al., 2021). Research and innovation are needed to determine how evolving telehealth technology can help providers perform virtual exams with high fidelity and safety, thereby improving pediatric rheumatology telehealth delivery.

The study conducted by Ruelos et al. (2021) about the perception of orthopedic patients regarding telehealth use stated that the majority of patients expressed that the system was easy to use (90.0%), is convenient (86.7%), and saves them time (83.3%). Additionally, nearly all (95%) patients agreed that their surgeon could answer their questions using the technology. Patient perspectives on the widespread adoption of telehealth, such as ease of use, privacy protection, and convenience, showed that these anticipated barriers might be some of the most significant advantages of telehealth (Ruelos et al., 2021).

The COVID-19 pandemic may have provided the momentum for telehealth to become a mainstay of many healthcare services as a form of care delivery in the future. However, many aspects need to be addressed so that the benefits of this technology can be maximized.

Limitations

The articles included in this study were all peer-reviewed articles published from 2008 to 2022. Credible online resources and books were not included as they posed potential coding complications and data analysis issues. For these reasons, the review may not have examined other pertinent articles. The majority of the included research was conducted in the U.S., Canada, Australia, and Great Britain. Due to this, this study may not have captured the whole picture as results from other places may not have been accounted. Although, there is the certainty that the results may not have differed significantly if more articles had been included.

Conclusion

Telehealth and telemedicine play an essential part in widening access to care and improving patient satisfaction. COVID – 19 pandemic has launched the popularity and usefulness of this technology in many facets of healthcare. Telehealth has poised not only for convenience for patients, but it has the potential to provide so many further benefits, including improving public health, relieving pressure on the healthcare workforce, and helping to reduce financial stress to many. Some of the studies identified barriers that hinder the telehealth/telemedicine system; such barriers were human factors in using the technology, training, conflicting state policies, and privacy. These barriers are worth visiting for future studies to address and perhaps draw a bigger picture of telehealth and telemedicine as valuable assets to the healthcare system.

Recommendations for Further Study

In this study, many articles focused on the patient, yet patient care does not only include patients, but also consists of the system and providers. Future studies may include looking at the other side of patient care on how telehealth affects doctors, nurses, and other healthcare providers. It is also essential to study how a unified telehealth system in the United States can be achieved. This will assist lawmakers and advocates in pressing the approval of existing policy proposals waiting for debates and discussions in the senate and congress. Some examples of proposed telehealth acts are S. 1704/H.R. 5981 (Telehealth Expansion Act 2021), H.R. 5506 (Rural Telehealth Access Task Force Act), and H.R. 4480 (Telehealth Coverage and Payment Parity Act). Along with many other proposed laws, it is crucial to public health professionals and advocates to keep awareness of the benefits of the telehealth system in the open to address any gaps in health not just for people living in remote places but for all who want to avail these kinds of services.

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Sundstrom, B., DeMaria, A. L., Ferrara, M., Meier, S., & Billings, D. (2019). “The closer, the better:” The role of telehealth in increasing contraceptive access among women in rural South Carolina. Maternal and Child Health Journal, 23(9), 1196–1205. http://dx.doi.org/10.1007/s10995-019-02750-3

Reisinger‐Kindle, K., Qasba, N., Cayton, C., Niakan, S., Knee, A., & Goff, S. L. (2021). Evaluation of rapid telehealth implementation for prenatal and postpartum Care visits during the COVID ‐19 pandemic in an academic clinic in Springfield, Massachusetts, United States of America. Health Science Reports, 4(4). https://doi.org/10.1002/hsr2.455

Rutherford, E., Noray, R., HEarráin, C. Ó., Quinlan, K., Hegarty, A., Ekpotu, L., Arize, C., Fabamwo, F., Alrubaiaan, A., Bhupalan, A., Alshehhi, A., Power, C., & Hill, A. D. K. (2020). Potential benefits and drawbacks of virtual clinics in general surgery: Pilot cross-sectional questionnaire study. JMIR Perioperative Medicine, 3(1), e12491. https://doi.org/10.2196/12491

Sanders, C., Rogers, A., Bowen, R., Bower, P., Hirani, S., Cartwright, M., Fitzpatrick, R., Knapp, M., Barlow, J., Hendy, J., Chrysanthaki, T., Bardsley, M., & Newman, S. P. (2012). Exploring barriers to participation and adoption of telehealth and telecare within the whole system demonstrator trial: A qualitative study. BMC Health Services Research, 12(1), 220. https://doi.org/10.1186/1472-6963-12-220

Schulder Rheuban, K., & Krupinski, E. A. (2018). Understanding telehealth access medicine. McGraw-Hill Medical. https://accessmedicine.mhmedical.com/book.aspx?bookID=2217#187794411

Scott, R., & Mars, M. (2015). Telehealth in the developing world: Current status and future prospects. Smart Homecare Technology and TeleHealth, 2015, 25. https://doi.org/10.2147/SHTT.S75184

Sharma, A., Bowman, R., Ettema, S. L., Gregory, S. R., Javadi, P., Johnson, M. D., Butcher, M. L., Mutua, E., Stack, B. C., & Crosby, D. L. (2021). Rapid telehealth implementation into an otolaryngology practice during the COVID ‐19 pandemic. Laryngoscope Investigative Otolaryngology, 6(3), 386–393. https://doi.org/10.1002/lio2.552

Steindal, S. A., Nes, A. A. G., Godskesen, T. E., Dihle, A., Lind, S., Winger, A., & Klarare, A. (2020). Patients’ experiences of telehealth in palliative home care: Scoping review. Journal of Medical Internet Research, 22(5), e16218. https://doi.org/10.2196/16218

Stout, K. A., & Martinez, K. (2011). Telehealth forging ahead: Overcoming barriers in licensure to improve access to Care for service members. International Journal of Telerehabilitation, 3(2), 23–26. https://doi.org/10.5195/IJT.2011.6081

Waqar-Cowles, L. N., Chuo, J., Weiss, P. F., Gmuca, S., LaNoue, M., & Burnham, J. M. (2021). Evaluation of pediatric rheumatology telehealth satisfaction during the COVID-19 pandemic. Pediatric Rheumatology, 19(1), 170. https://doi.org/10.1186/s12969-021-00649-4

Watts, K. A., Malone, E., Dionne‐Odom, J. N., McCammon, S., Currie, E., Hicks, J., Tucker, R. O., Wallace, E., Elk, R., & Bakitas, M. (2021). Can you hear me now?: Improving palliative care access through telehealth. Research in Nursing & Health. http://dx.doi.org/10.1002/nur.22105

Weissman, R. S., Bauer, S., & Thomas, J. J. (2020). Access to evidence‐based Care for eating disorders during the COVID ‐19 crisis. International Journal of Eating Disorders, 53(5), 639–646. https://doi.org/10.1002/eat.23279

White, J., Byles, J., & Walley, T. (2022). The qualitative experience of telehealth access and clinical encounters in Australian healthcare during COVID-19: Implications for policy. Health Research Policy and Systems, 20(1), 9. https://doi.org/10.1186/s12961-021-00812-z

Wilkinson, J. R., Spindler, M., Wood, S. M., Marcus, S. C., Weintraub, D., Morley, J. F., Stineman, M. G., & Duda, J. E. (2016). High patient satisfaction with telehealth in Parkinson disease: A randomized controlled study. Neurology: Clinical Practice, 6(3), 241–251. https://doi.org/10.1212/CPJ.0000000000000252

Young, J. D., & Badowski, M. E. (2017). Telehealth: Increasing Access to High Quality Care by Expanding the role of technology in correctional medicine. Journal of Clinical Medicine, 6(2), E20. https://doi.org/10.3390/jcm6020020

Young, L. B., Foster, L., Silander, A., & Wakefield, B. J. (2011). Home telehealth: Patient satisfaction, program functions, and challenges for the care coordinator. Journal of Gerontological Nursing, 37(11), 38–46. https://doi.org/10.3928/00989134-20110706-02

APPENDIX A. ARTICLE SELECTION PROCESS

Figure 1. Study Selection Flow Diagram

APPENDIX B. SYSTEMATIC LITERATURE REVIEW

Table 1. List of Reviewed Articles

Author, Year	Article Title	Focus of study
Jones et al., 2012	Acceptability and cost-effectiveness of military telehealth mental health screening.	Access to Care
Weissman et al., 2020	Access to evidence-based Care for eating disorders during the COVID-19 crisis	Access to Care
Jester et al., 2020	Changes in access to educational and healthcare services for individuals with intellectual and developmental disabilities during COVID‐19 restrictions	Access to Care
Jong et al., 2019	Enhancing access to care in northern rural communities via telehealth	Access to Care
Pal et al., 2021	Enhancing Cancer care of rural dwellers through telehealth and engagement (ENCORE): protocol to evaluate effectiveness of a multi-level telehealth-based intervention to improve rural cancer care delivery	Access to Care
Bate et al., 2021	Effect of the COVID‐19 induced phase of massive telehealth uptake on end‐user satisfaction	Access to care & Patient satisfaction
Reisinger-Kindle et al., 2021	Evaluation of rapid telehealth implementation for prenatal and postpartum Care visits during the COVID-19 pandemic in an academic clinic in Springfield, Massachusetts, United States of America	Access to care
Goncalves et al., 2017	Expanding Primary Care Access: A Telehealth Success Story	Access to Care
Young et al., 2011	Home Telehealth: Patient Satisfaction, Program Functions, and Challenges for the Care Coordinator	Patient satisfaction
Dean et al., 2019	Improving value and access to specialty medical care for families: a pediatric surgery telehealth program	Access to care & Patient satisfaction
Nicosia et al., 2021	Leveraging Telehealth to improve access to Care: a qualitative evaluation of Veterans’ experience with the VA TeleSleep program	Access to Care
Polinski et al., 2016	Patients’ Satisfaction with and Preference for Telehealth Visits	Access to Care
Chang et al., 2021	Rapid Transition to Telehealth and the Digital Divide: Implications for Primary Care Access and Equity in a Post-COVID Era	Access to Care
Jhaveri et al., 2020	"Soup cans, brooms, and Zoom:" Rapid conversion of a cancer survivorship program to telehealth during COVID-19	Access to care & Patient satisfaction
Imlach et al., 2020	Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences	Access to care & Patient satisfaction
O’Donovan et al., 2020	Telehealth for delivery of hemophilia comprehensive care during the COVID-19 pandemic	Access to care & Patient satisfaction
Aziz et al., 2020	Telehealth for High-Risk Pregnancies in the Setting of the COVID-19 Pandemic	Access to care
Gadenz et al., 2021	Telehealth to support referral management in a universal health system: a before-and- after study	Access to Care
Young et al., 2017	Telehealth: Increasing Access to High Quality Care by Expanding the Role of Technology in Correctional Medicine	Access to Care
Powell et. Al., 2018	Patient and Health System Experience with Implementation of an Enterprise-Wide Telehealth Scheduled Video Visit Program: Mixed-Methods Study	Access to care & Patient satisfaction
Garvin et at., 2021	Use of Video Telehealth Tablets to Increase Access for Veterans Experiencing Homelessness	Access to Care
Layfield et al., 2020	Telemedicine for head and neck ambulatory visits during COVID‐19: Evaluating usability and patient satisfaction	Patient satisfaction
White et al., 2022	The qualitative experience of telehealth access and clinical encounters in Australian healthcare during COVID-19: implications for policy	Access to Care
Hobson et al., 2019	Using telehealth in motor neuron disease to increase access to specialist multidisciplinary Care: a UK-based pilot and feasibility study	Access to Care
Gilkey et al., 2021	Using Telehealth to Deliver Primary Care to Adolescents During and After the COVID-19 Pandemic: National Survey Study of US Primary Care Professionals	Access to Care
Bradford et al., 2015	Awareness, experiences and perceptions of telehealth in a rural Queensland community	Patient satisfaction
Jeste et al., 2020	Changes in access to educational and healthcare services for individuals with intellectual and developmental disabilities during COVID‐19 restrictions	Patient satisfaction
Adams et al., 2021	Patient satisfaction and acceptability with telehealth at specialist medical outpatient clinics during the COVID-19 pandemic in Australia	Patient satisfaction
Steindal et al., 2020	Patients’ Experiences of Telehealth in Palliative Home Care: Scoping Review	Patient satisfaction
Rutherford et al., 2020	Potential Benefits and Drawbacks of Virtual Clinics in General Surgery: Pilot Cross-Sectional Questionnaire Study	Patient satisfaction
Sharma et al., 2021	Rapid telehealth implementation into an otolaryngology practice during the COVID-19 pandemic	Patient satisfaction
Paterson et al., 2020	The Role of Telehealth During the COVID-19 Pandemic Across the Interdisciplinary Cancer Team: Implications for Practice	Patient satisfaction
O’Connor et al., 2016	Using Telehealth to Reduce All-Cause 30-Day Hospital Readmissions among Heart Failure Patients Receiving Skilled Home Health Services	Patient satisfaction
Gordon et al., 2017	Virtual Visits for Acute, Nonurgent Care: A Claims Analysis of Episode-Level Utilization	Patient satisfaction
Graziano et al., 2021	Psychological interventions during COVID pandemic: Telehealth for individuals with cystic fibrosis and caregivers	Patient satisfaction
Howren et al., 2020	Virtual rheumatology appointments during the COVID-19 pandemic: an international survey of perspectives of patients with rheumatic diseases	Patient satisfaction
Young et al., 2011	Home Telehealth: Patient Satisfaction, Program Functions, and Challenges for the Care Coordinator	Patient satisfaction
Bove et al., 2013	Managing hypertension in urban underserved subjects using telemedicine—A clinical trial	Patient satisfaction
Ly et al., 2017	The individual and contextual determinants of the use of telemedicine: A descriptive study of the perceptions of Senegal’s physicians and telemedicine projects managers	Patient satisfaction
Ashwood et al., 2017	Direct-To-Consumer Telehealth May Increase Access to Care but Does Not Decrease Spending	Access to Care
Watts et al., 2021	Can you hear me now? Improving palliative care access through telehealth	Access to Care
Stingley & Schultz, 2014	Helmsley Trust Support For Telehealth Improves Access to Care in Rural And Frontier Areas	Access to care
Nandra et al., 2019	Telehealth provides a comprehensive approach to the surgical patient	Access to Care
Sundstrom et al., 2019	“The Closer, the Better:” The Role of Telehealth in Increasing Contraceptive Access Among Women in Rural South Carolina	Access to Care
Perez, 2021	Expanding Access to Specialty Care Using Video-Telehealth: The Case for Functional Neurological Disorder	Access to Care
Maurice et al., 2020	Improving Access to Bariatric Surgery for Rural and Remote Patients: Experiences from a State-Wide Bariatric Telehealth Service in Australia	Access to Care
Moffat & Eley, 2010	The reported benefits of telehealth for rural Australians	Access to Care
Brenes et al., 2011	Benefits and Challenges of Conducting Psychotherapy by Telephone	Access to Care
Bhatia, 2021	Telehealth and COVID-19: Using technology to accelerate the curve on access and quality healthcare for citizens in India	Access to care
Seto et al., 2019	Opportunities and Challenges of Telehealth in Remote Communities: Case Study of the Yukon Telehealth System	Access to Care

2

2

,

CHAPTER 1: INTRODUCTION

Student

National University

COH 694B

July 16, 2023

CHAPTER 1: INTRODUCTION

Introduction to the problem

Access to healthcare in rural communities is a challenge globally (Tan, 2022). Rural areas have little development, which restricts the communities from accessing proper healthcare services (Rodgers & Yee, 2014). Health is the most important basic need, and everyone is entitled to quality services. However, this is not the case because millions worldwide still struggle to get effective and efficient services (Charalambous, 2023).

Background of the Problem

Rural communities in the United States have lagged when it comes to accessing quality healthcare. This has been the case since time immemorial and is a great concern since it affects the overall health situation in the country. More than 18% of Americans (60 million) live in rural areas; on average, they are older than urban dwellers (US Government Accountability Office, 2023). Additionally, they are comparatively poorer than those who reside in urban areas. Their access to healthcare is challenging as they cannot afford the best services. Resources are also limited, affecting the quality of care they can access (Patton, 2014).

Statement of the Problem

The problem is the lack of access to proper healthcare for rural communities in the United States despite health being a basic need. This challenge needs to be addressed and a possible solution found.

Purpose of the Study

The study aims to understand why rural communities in the United States have challenges accessing healthcare. The study will also reveal factors leading to this situation. A study must have a purpose (Miller & Wilson, 2014).

Research Question

This project looks forward to answering the following research question: what factors lead to poor access to healthcare by communities in rural America?

Significance of the Study

This study is significant because it will reveal the factors that lead to poor access to healthcare in rural communities within the United States. The findings will also include suggestions and recommendations that can be implemented to solve the problem. Research should be useful in revealing information that can help solve problems (Griffiths, 2009).

Assumptions

The sample used in the research will represent the entire population. More than 60 million are affected and cannot be interrogated; they will be represented. Samples represent the population (Arnab, 2017). The research will also be done using reliable methods and tools; therefore, the outcomes will be valid.

Limitations

There are financial constraints. Therefore, the research will not be extensive. The sample will also be small for easier handling, although it might not reveal the accurate reality of the population. The level of accuracy might be 95%. Studies have challenges that affect the outcomes.

Summary

Many studies have been conducted regarding different areas of healthcare. Still, they have not paid attention to why there is a problem with access to healthcare in rural communities within the United States. This research will find why the situation is the way it is and recommend possible solutions to the problem. More literature related to the topic will be analyzed to help understand the facts (Creswell, 2014). Literature is important as it provides additional information from other researchers' discoveries (Bowling, 2023).

References

Arnab, R. (2017). Survey Sampling Theory and Applications. Amsterdam: Elsevier.

Bowling, A. (2023). Research Methods in Health: Investigating Health and Health Services. Open University Press.

Charalambous, P. (2023). Less Staff, Longer Delays, and Fewer Options: Rural America Confronts a Healthcare Crisis. Retrieved from https://abcnews.go.com/Health/staff-longer-delays-fewer-options-rural-america-confronts/story?id=97911613

Creswell, J. (2014). Research Design. London: SAGE.

Griffiths, F. (2009). Research Methods for Healthcare Practice. Los Angeles: SAGE.

Miller, K. & Wilson, S. (2014). Cognitive Interviewing Methodology. Hoboken: Wiley.

Patton, M. (2014). Qualitative Research & Evaluation Methods. London: SAGE.

Rodgers, P. & Yee, J. (2014). The Routledge Companion to Research Design. London: Routledge.

Tan, W. (2022). Research Methods: A Practical Guide for Students and Researchers. World Scientific.

US Government Accountability Office. (2023). Why Healthcare is Harder to Access in Rural America. Retrieved from https://www.gao.gov/blog/why-health-care-harder-access-rural-america

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6

Chapter 4. Data Collection, Analysis, and Results

Students name

National University

COH 694B

August 6, 2023

CHAPTER 4. DATA COLLECTION, ANALYSIS, AND RESULTS

Introduction

In the present chapter, I will discuss the study data collection methods, procedures, and considerations employed during data gathering and examination. The methods and steps to identify and select the selected articles used in this study will be explained. The reviewed articles' results are also presented in this chapter.

Data Collection Procedures

The current qualitative study using a grounded theory design was done to investigate some of the factors that lead to poor access to healthcare among the American communities living in rural America. Previous research has revealed that rural communities in the United States have challenges accessing proper health care. This study, therefore, focused on unearthing the reasons for the situation and providing recommendations. The study also examined how medical technology can improve healthcare access in rural areas. The study focused on a review of published literature on the topic and related subjects.

From the onset of the study, several articles were retrieved from different databases and were subjected to further scrutiny. A total of (n=77) articles were identified and selected initially. After reading the abstracts of the articles, which include article overview, results, discussion, and conclusion, (n=53) were identified but (n=13) articles were deleted from the list of identified because they did not meet the inclusion criteria. The remaining articles ( n = 40) were grouped into three; one group talked about access to care ( n = 19); the second group was all about how access can be improved ( n =11); the third group focused on access and improvement strategies ( n = 6). Figure 1: (Appendix 1) and Table 1: (Appendix 2) show the article identification, selection map, and articles incorporated in the review.

General overviews of the article findings indicate that many obstacles, including demography, terrain, poor internet connection, lack of insurance coverage, and poor staffing of the health facilities, hinder healthcare access in rural America. The authors agreed that mobile health, telehealth, and telemedicine technology could help increase healthcare access in rural areas. The role of medical technology in delivering health care to people in rural areas presents an exclusive avenue where this system/s was used to address patient needs. Still, the focus of this study was access to care and eliminating barriers.

Data Analysis and Results

The titles, authors' names, and the date of publication of the articles reviewed in this study are provided in Appendix 2. The findings of the studies indicate that lack of access to healthcare or limited access is a huge problem that the American healthcare system has to address. For instance, a study that Rural Health Information Hub did. (2022) that American citizens are entitled to access at least basic healthcare services such as primary care, behavioral care, dental care, and public health services, among others. However, this is not possible in rural America, where it is estimated that more than 45% of the population has no or limited access to healthcare services. Similarly, authors of the articles that were reviewed in this study agree that access to healthcare in rural America is imperative for several reasons presented in Table 1 below:

No	Importance Of Healthcare Services Access	Article In-Text Citation
1.	Improving overall physical, mental, and social health status	(Rural Health Information Hub, 2022)
2.	Prevention of diseases	(NCSL, 2020)
3.	Detection, diagnosis, and treatment of illnesses	(HRSA, 2022)
4.	Improving the quality of care	(Griffiths, 2009)
5.	Avoiding preventable loss of life	(Federal Emergency Management Agency (2022)
6.	Increasing life expectancy	(Singh & Siahpush, 2013)

Data and findings from the studies that have focused on understanding the impacts of limited or no access to health care services in rural areas in Table 1 above show an urgent need to solve the health care problem. For instance, a study by Singh and Siahpush (2013) noted that life expectancy in rural America was 76.7 years, while in urban was 79.1 years.

The article's authors found that telehealth is a significant solution to increase access to healthcare in rural communities in the United States. This innovative solution enables patients to receive healthcare services without necessarily meeting with providers. Telehealth is usually done online, implying that there needs to be a stable internet service on both ends (Mayo Clinic, 2022). Mobile health clinics are in place to increase access to healthcare in rural communities in the United States (Waldrop & Gee, 2022). Mobile clinics enable healthcare professionals to provide healthcare services where the patient is. In conventional healthcare, the patient visits the healthcare facility. The delivery of quality healthcare is a collective responsibility. It requires the input of different stakeholders to make it achievable. Rural communities are challenging to reach. Therefore, organizations need to play different roles in ensuring people access services.

An organization such as Families USA accesses the most rural areas in the United States and provides them with healthcare services (Tulane University School of Public Health and Tropical Medicine, 2023). The authors agreed that solutions could be implemented once the barriers have been addressed, and locals will start experiencing the benefits of accessing quality healthcare (Rural Health Information Hub, 2023). One of the barriers addressed is poor transportation. If this is handled, there will be better roads in the rural areas, which implies that it will be easier for locals to reach healthcare facilities to be treated for different needs.

References

AAMC. (2017). Health disparities affect millions in rural U.S. communities. Retrieved from https://www.aamc.org/news/health-disparities-affect-millions-rural-us-communities

Advent Health University (2022). How to improve healthcare in rural areas. Retrieved from https://www.ahu.edu/blog/improve-healthcare-in-rural-areas

Bergum, A. & Catlin, B. (2016). What works? Strategies to improve rural health. Retrieved from https://www.countyhealthrankings.org/reports/what-works-strategies-improve-rural-health

Bowling, A. (2023). Research methods in health: Investigating health and health services. Open University Press.

CDC. (2023). About rural health. Retrieved from https://www.cdc.gov/ruralhealth/about.html

Charalambous, P. (2023). Less staff, longer delays, and fewer options: Rural America confronts a healthcare crisis. Retrieved from https://abcnews.go.com/Health/staff-longer-delays-fewer-options-rural-america-confronts/story?id=97911613

CMS. (2022). Rural health strategy. Retrieved from https://www.cms.gov/files/document/rural-strat-guide-08-may.pdf

Federal Emergency Management Agency. (2022). The rural fire problem in the United States. Retrieved from https://www.usfa.fema.gov/downloads/pdf/statistics/rural.pdf

Griffiths, F. (2009). Research Methods for Healthcare Practice. Los Angeles: SAGE.

Harvard University (2019). Poll: Financial insecurity and limited access to health care plague many rural Americans. Retrieved from https://www.hsph.harvard.edu/news/hsph-in-the-news/poll-financial-insecurity-and-limited-access-to-health-care-plague-many-rural-americans/

HRSA (2022). Rural access to healthcare services request for information. Retrieved from https://www.hrsa.gov/rural-health/rfi-rural-health-care-access

Mayo Clinic (2022). Telehealth: Technology meets healthcare. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878#:~:text=What%20is%20telehealth%3F,technology%20you%20use%20from%20home.

NCSL (2020). Improving rural health: State policy options for increasing access to healthcare. Retrieved from https://www.ncsl.org/health/improving-rural-health

PhRMA. (2022). Addressing health disparities – Addressing barriers in health. Retrieved from https://phrma.org/equity?utm_campaign=2023-q2-equ-acc&utm_medium=pai_srh_cpc-ggl-adf&utm_source=ggl&utm_content=clk-pat-tpv_scl-geo_std-usa-all-pai_srh_cpc-ggl-adf-EquityEvergreenSearchWCDCKeyStatesMemberCo2-pra_equ-edu-inf-lrm-soc_txt-std-vrb-adf&utm_term=&gclid=Cj0KCQjw8NilBhDOARIsAHzpbLD_iy8DNZDGQv_622Qw48OgVFy79se3wPj1a–2uRnhwg7SynBEUWEaAoYaEALw_wcB

Regis College. (2023). Improving access to rural healthcare. Retrieved from https://online.regiscollege.edu/blog/rural-health-care/

Rural Health Information Hub. (2022). Health access in rural Communities. Retrieved from https://www.ruralhealthinfo.org/topics/healthcare-access

Rural Health Information Hub. (2023). Families USA. Retrieved from https://www.ruralhealthinfo.org/organizations/968

Rushton, S. & Youde, J. (2017). Routledge Handbook of global health security. Routledge.

Samuels, K., McClellan, M., Patel, K., & Darling, M. (2014). Transforming rural healthcare: High-quality, sustainable access to quality care. Retrieved from https://www.brookings.edu/articles/transforming-rural-health-care-high-quality-sustainable-access-to-specialty-care/

Singh, G. & Siahpush, M. (2013). Widening rural-urban disparities in life expectancy, U.S., 1969-2009. American Journal of Preventive Medicine, 46(2): 19-29.

Strasser, R. (2003). Rural health around the world: Challenges and solutions. Family Practice, 20(4): 457-463.

Tulane University School of Public Health and Tropical Medicine. (2023). How to improve healthcare in rural areas. Retrieved from https://publichealth.tulane.edu/blog/how-to-improve-health-care-in-rural-areas/

United Nations (2015). A New U.N. report finds most of the world's rural populations excluded from healthcare access. Retrieved from https://www.un.org/sustainabledevelopment/blog/2015/04/new-un-report-finds-bulk-of-worlds-rural-populations-excluded-from-healthcare-access/#:~:text=The%20ILO's%20findings%20%E2%80%93%20published%20in,cent%20of%20rural%20inhabitants%20are

US Government Accountability Office. (2023). Why healthcare is harder to access in rural America. Retrieved from https://www.gao.gov/blog/why-health-care-harder-access-rural-america

Waldrop, T. & Gee, E. (2022). How states can expand healthcare access in rural communities. Retrieved from https://www.americanprogress.org/article/how-states-can-expand-health-care-access-in-rural-communities/

,

Chapter 3: Methodology

Student name

National University

COH 694B

July 31, 2023

CHAPTER 3: METHODOLOGY

The research design that will be used in this study is the qualitative research method. This type of research method focuses on collecting and analyzing non-numerical data to understand the reality of the situation (Bowling, 2023). Different research methods can be used in a study; therefore, the researcher needs to understand the nature of their research to use the most effective method to collect and analyze data. This research will use qualitative study because it has various benefits. It addresses two important questions "How?" and "Why?". This ensures that detailed data is collected, and the reality will be revealed through analysis. Interviews are not restricted. Therefore, more profound and more helpful information will be gathered. The qualitative research method is beneficial because it makes it possible to use multiple ways to collect data. The technique is also efficient because few resources are used, but the output is enormous.

Research Question

A research question is what the research focuses on. When research is conducted, it intends to make some revelations. Research questions guide the process. In other words, the entire research is focused on answering the research questions. In this study, the research question is:

What factors lead to poor access to healthcare by communities in rural America?

Previous research has revealed that rural communities in the United States have challenges accessing proper healthy care. This study will focus on unearthing the reasons for the situation and providing recommendations.

Description of the Participants

Participants are the people the research is focused on; they are the subjects the research will target to collect data (Bowling, 2023). Selecting participants is one of the most essential steps in a research process. They are the data sources; therefore, they should be chosen carefully. In this research, participants were residents of rural areas in the United States. They are the recipients of the services and will play a critical role in providing information concerning the research question. These participants were selected because they were directly affected by the situation. They will provide first-hand information that will help in understanding the problem.

Another lot of participants is made of healthcare service providers. These are professionals of different capacities in the healthcare sector working in facilities in the rural communities of the United States. They were selected randomly from different healthcare facilities in the rural areas. They have a deeper understanding of why their services are insufficient. They will be essential in providing information, especially about the resources available. The recommendations made after data analysis will primarily rely on the feedback received from healthcare professionals. They come in direct contact with the patients and the situation on the ground; therefore, they have helpful information to help make decisions to solve the problems.

Government agencies responsible for different types of infrastructure, such as roads and communication, will also participate. They will help address how infrastructure can be used to increase accessibility in rural areas. Every research has different participants. It is vital to ensure that the participants have relevant information about the study.

Instrumentation

The internet is a rich source of information. Several websites were used to obtain data. One of the websites used is www.gao.gov . This is the website for the U.S. Government Accountability Office, which is responsible for assisting Congress in overseeing federal programs and operations to make sure they are accountable to the American people. Rural health is one of the areas that the GAO website has valuable information, which is why it was used to obtain data. The U.S. Department of Health also has vital statistics about access to healthcare services by rural communities in the United States. These websites are reliable because the data and information available are based on professional research. They have factual content that can be used to make strategic decisions. Instruments used in research should be reliable because their content must be accurate and research-based (Samuels et al, 2014).

Data Collection Procedures

Informed consent was used in the process. Respondents and participants were educated about the research, its purpose, procedures, and potential impacts. They voluntarily decided to take part in the process. Informed consent is an important element in healthcare research. It is in line with ethical requirements. Participants have a right to understand what is entailed in a research process (Rushton & Youde, 2017). Interviews and questionnaires were used to collect data. They contained sets of questions that aimed at the primary research question. Most of the open-ended questions allowed respondents to speak their minds. Depending on the nature of the research, different data collection procedures can be used to obtain the best outcomes.

Data Analysis and Results

The most common type of data collected was ordinal data. This data type has ordered or ranked categories (Griffiths, 2009). For instance, ordinal data ranks the levels of satisfaction of patients. To prepare data for analysis, it will first be assembled from the different tools used in the collection process. The next step involves cleaning. This implies that errors will be removed or corrected to ensure everything is accurate. The data will then be labeled so that it is easy to identify different data sets. Lastly, the data will be validated and visualized. The data will be coded depending on the participants it collected from. For instance, data from residents will be coded differently from those from healthcare professionals. Data will be initially analyzed through the grounded theory. The methodology explains the experiences of people participating in the research; it gives meaning to their interactions.

Ethical Considerations

The first ethical consideration is the use of the informed consent protocol. Participants were educated about the research, and they confirmed that they understood what it entailed. They willingly took part in the process. The study promotes the aims by revealing problems in the system and recommending how the problem can be solved. It also enables the values of collaborative work because different stakeholders are putting their efforts together to get the job done. The research promotes moral and social values by focusing on improving accessibility to healthcare in rural communities in the United States.

References

Bowling, A. (2023). Research methods in health: Investigating health and health services. Open University Press.

Griffiths, F. (2009). Research Methods for Healthcare Practice. Los Angeles: SAGE.

Rushton, S. & Youde, J. (2017). Routledge Handbook of global health security. Routledge.

Samuels, K., McClellan, M., Patel, K., & Darling, M. (2014). Transforming rural healthcare: High-quality, sustainable access to quality care. Retrieved from

,

CHAPTER 2: LITERATURE REVIEW

Student

National University

COH 694B

July 23, 2023

CHAPTER 2: LITERATURE REVIEW

Challenges in Accessing Healthcare in Rural Areas Worldwide

Healthcare is one of the basic human needs in the sense that it deals with the health of people. Regardless of the situation, healthcare is a fundamental need that must be met. Despite the sensitivity of healthcare, millions of people across the globe still have challenges when it comes to accessing healthcare. Rural communities are among the most affected by the lack of proper access to healthcare. According to the United Nations, more than 56% of people living in rural areas cannot access critical healthcare services (UN, 2015). Different countries have different levels of access but generally, all rural areas worldwide have inadequate access to healthcare, and those who are lucky to access it, do not get the right quality that guarantees them efficiency and effectiveness. It is a global challenge that must be addressed to ensure equity in access to healthcare services regardless of location.

One of the significant reasons why rural communities across the globe do not have access to proper healthcare services is the lack of adequate infrastructure at the available healthcare facilities. It should be noted that healthcare facilities require costly investment so that necessary equipment can be availed for the locals to be served as they deserve. However, this is not the case, as most facilities in local areas lack even the basic equipment (Samuels et al. 2014). This situation is attributed to decades of underinvestment or lack of investment in the healthcare sector in rural areas. National health systems have continually neglected rural areas, making them lag in development. As a result, the local communities are deprived of essential services that could mean the difference between life and death for them (Charalambous, 2023).

The law guarantees healthcare in many governments, and all citizens are entitled to adequate healthcare. Despite all these ideal situations, the reality is different. In most countries, health sector development focuses only on urban areas because of the significant demand available. Rural areas are usually neglected and this takes a toll on the communities. The lack of sufficient workers in rural healthcare facilities worsens the situation. Most professionals prefer working in urban centers due to the benefits and opportunities they are exposed to. As a result, healthcare facilities in rural areas are understaffed, creating a considerable workload on available workers. This affects their ability to deliver the best healthcare services and leads to poor access to healthcare by the locals. The International Labor Organization reports that 23% of healthcare professionals are deployed to rural areas even though half of the world population resides in rural areas. As aforementioned, the rates differ from one country to another but generally, it is a global problem.

Inadequate funding significantly contributes to rural areas' lack of essential healthcare services. There is a massive gap in terms of resources as well as financial resources between healthcare facilities in urban centers and rural areas. Lack of workers, inadequate facilities, and out-of-pocket payments have limited access to healthcare. This problem has existed since time immemorial and continues to affect different rural communities across the globe. As much as people wish to access the best services, it is not easy because of the numerous limitations. In other words, there is more demand than supply of healthcare services in rural areas. Many people require the services but for different reasons, they cannot get them. This limits their access to healthcare services.

Lack of Access to Healthcare for Rural Communities in the United States

Access to healthcare services is critical for all Americans. Healthcare is a fundamental need that every citizen is entitled to, regardless of where they live. Rural residents face different barriers to accessing quality healthcare, putting them at various risks (AAMC, 2017). A study conducted in 2014 by RUPRI revealed that there is a need for additional measures to be taken to reduce or eliminate barriers that hinder local communities in the United States from accessing quality healthcare services. According to the health requirements in the United States, citizens should confidently and conveniently access at least basic healthcare services such as primary care, behavioral care, dental care, and public health services, among others (Rural Health Information Hub, 2022). Accessing such healthcare services is important for many reasons, which include the following:

· Improving overall physical, mental, and social health status

Lack of access to quality healthcare denies rural communities in the United States the chance to improve their overall health. Accessing proper healthcare services ensures that different dimensions of health are catered for. It is essential for rural communities to access healthcare as this will ensure their overall health status is improved.

· Prevention of diseases

Accessing proper healthcare would enable rural communities to prevent diseases (NCSL, 2020). Many diseases are preventable but if rural communities cannot access the right healthcare services, they will not prevent diseases. They are at risk of suffering from a wide variety of health complications.

· Detecting, diagnosing, and treating illnesses

Proper access to quality healthcare makes detecting, diagnosing, and treating illnesses possible. When illnesses are detected early enough, they can be handled and the damage controlled (HRSA, 2022). However, rural communities do not experience this due to a lack of access to healthcare. Some of them have undetected illnesses; it could be too late by the time they are detected.

· Improving the quality of life

To a large extent, the quality of life is determined by the quality of healthcare received. To improve their quality of life, rural communities need to access quality healthcare services (Griffiths, 2009). Without access to the right quality of healthcare, the quality of life is compromised, putting the locals at risk.

· Avoiding preventable loss of life

Studies have also revealed that access to proper healthcare can save a life. According to the Federal Emergency Management Agency (2022), 8% of fires in the United States occur in rural areas. These are emergency cases that need immediate attention. Without access to healthcare, such cases lead to loss of life.

· Increasing life expectancy

Everyone wants to live a long, healthy life, but this is determined by the quality of healthcare they receive. According to the American Journal of Preventive Medicine, it is 76.7 years, while in urban centers, it is 79.1 years (Singh & Siahpush, 2013). The low life expectancy in rural areas can be increased by increasing access to quality healthcare. Inadequate healthcare compromises the quality of life and this reduces life expectancy.

Residents in rural areas are often disadvantaged that they miss out on the basic benefits of access to quality healthcare services. Healthcare services are limited and the available ones are not timely. This is a challenge that compromises the quality of healthcare received. In instances where adequate healthcare has been availed in rural communities in the United States, there are still factors that make it difficult for the residents to access the services (Bergum & Catlin, 2016).

Bridging the Gap to Increase Access to Healthcare in Rural Communities in the United States

Mobile Health

Mobile health clinics are in place to increase access to healthcare in rural communities in the United States (Waldrop & Gee, 2022). Mobile clinics enable healthcare professionals to provide healthcare services where the patient is. In conventional healthcare, it is the patient who visits the healthcare facility. However, in this case, it is the reverse. Mobile health providers are always on the move to ensure patients get the services in the comfort of their homes or places of work. They are usually referred to as "clinics on wheels" because they are always on the move. They help solve transportation problems that most residents in rural communities face. In 2020, a study by the International Journal of Equity on Health reported that 55% of mobile health clients are women and racial minorities at 59%. The study also revealed that most recipients of mobile services were not insured. Mobile clinics receive financial support from philanthropists because they primarily serve patients with financial problems.

Telehealth

Telehealth is a significant solution to increase access to healthcare in rural communities in the United States. This innovative solution enables patients to receive healthcare services without necessarily meeting with providers. Telehealth is usually done online, implying that there needs to be a stable internet service on both ends (Mayo Clinic, 2022). A smartphone or computer is also required for this service to be offered. Telehealth increases access to healthcare by reducing waiting time. In others, services are provided as soon as they are needed. Through a video call, a medical officer describes what patients should do to care for themselves (Regis College, 2023). This has ensured that healthcare services are available even in the most rural locations.

Partnerships and Collaborations

The delivery of quality healthcare is a collective responsibility. It requires the input of different stakeholders to make it achievable. Rural communities are challenging to reach. Therefore, organizations need to play different roles in ensuring people access services. An organization such as Families USA accesses the most rural areas in the United States and provides them with healthcare services (Tulane University School of Public Health and Tropical Medicine, 2023). The organization partners with others that cannot physically reach the rural areas. They provide resources such as finances and other items needed in service delivery. In other words, different organizations join their efforts and play different roles to ensure rural communities in the United States can access quality healthcare. As aforementioned, healthcare is a collective responsibility and various stakeholders have different roles to play to provide rural communities in the United States can access proper services. Partnerships and collaborations are essential because they enable rural communities to experience the following benefits:

· Efficient delivery of care

Partnerships ensure the available resources are utilized correctly (Rushton & Youde, 2017). There are no wastes, implying that maximum output is received from minimal resources.

· Improved services and performance

Partnerships and collaborations increase rural communities' resources, leading to improved services and better performance (PhRMA, 2022). Providers are motivated and patients are satisfied.

· More flexibility in terms of payment options

Flexibility in payment models is a benefit brought through partnerships and collaborations. Rural communities have a variety of options that they can use to make payments for healthcare services received (Tulane University School of Public Health and Tropical Medicine, 2023).

· More recruitment and retention of staff

Partnerships provide more resources, enabling rural healthcare facilities to recruit more employees. An increase in staff is good news for local communities in the United States. It allows them to receive better services because there is more manpower.

When smaller local facilities partner with larger ones, the rural communities are the greatest beneficiaries because they are the final consumers of the services.

Common Barriers to Access to Health by Rural Communities in the United States

Despite the efforts by different agencies and stakeholders to make sure rural communities can access quality healthcare, many barriers still hinder them from achieving their purpose. There are obstacles that they must deal with before services are delivered to rural communities.

Scarcity of Services

One of the significant barriers to accessing quality health care in rural communities in the United States is the scarcity of services (Harvard University, 2019). It is noted that some services need a lot of investment to be availed. However, this is not the case. Most rural healthcare facilities only offer essential services and this limits what communities can access. When patients need advanced care, they have to travel to cities or major urban centers. The lack of such services in rural areas implies that most people cannot access them. Most facilities only offer primary basic care and cannot handle more complicated healthcare problems. Healthcare is about having a variety of services. When services ate limited, access is also limited.

Lack of Trained Physicians

Most trained physicians prefer working in urban areas because they get better incentives and are exposed to more opportunities that can help them to advance in their careers. This is a situation that limits the trained personnel available at rural healthcare facilities. Physicians who are not well trained cannot offer all the services patients need. Patients are not guaranteed that they access all the services that they need. This is a major barrier that interferes with the provision of healthcare services for rural communities in the United States. Sufficient staffing is required to provide the needed services so that patients can be served as they deserve. The lack of trained physicians implies that not all services can be offered. It is a situation that does not promote access to healthcare.

Transportation Challenges

Transportation is an important element in the delivery of healthcare. Without proper transport, it isn't easy to access healthcare. Rural areas have poor road networks, making it difficult for patients to get to a hospital. They spend too much time on the road and depending on the patient's condition, the outcome might be undesirable. Most healthcare facilities in rural areas also depend on roads to deliver supplies. Suppliers use roads to provide different items needed in the facilities. Due to poor roads, it is a challenge for the supplies to reach the facilities on time. In instances where perishable drugs should be delivered to facilities, it is a challenge because they are often given late, and sometimes they are already expired by the time they are delivered. Poor roads make transport difficult, which challenges patients and other stakeholders who need to be physically at the healthcare facility for different reasons.

Poor Internet Connectivity

The modern world is digitally connected and heavily relies on the internet for communication and research, among other important activities. Communities in rural areas do not experience the full benefits of the Internet because of poor connectivity. It is also tricky for telehealth to be operated when there is no internet. This is a concept where a healthcare professional links up with a patient through video calls or other forms of online communication (Strasser, 2003). It is a service that requires stable and fast internet connectivity. However, most rural areas in the United States are not lucky enough to access high-speed internet. This implies that the services they receive are limited. In the modern world, it is difficult to access even the most basic of services without the internet. The impact is felt in the healthcare sector as stakeholders cannot effectively be in touch with one another.

Healthcare facilities also need an internet connection to interact with other stakeholders. The lack of internet makes this communication difficult and significantly limits the services that can be offered in the facility.

Benefits of Accessible Health to Rural Communities in the United States

There are dozens of barriers to access to quality healthcare in rural communities in the United States. Most of these barriers are similar in most of the places. Before the community can realize benefits, the barriers must be eliminated. It should be noted that for a problem to be solved, it must first be understood (Bowling, 2023). It is the responsibility of relevant stakeholders, such as decision-makers, to understand the different barriers faced in different rural areas of the United States. Once the obstacles have been understood, corrective solutions can be devised to ensure they are solved in the best way possible (Advent Health University, 2022). Studies have indicated that organizations need to invest in understanding a problem before investing in implementing a solution.

Once the barriers have been addressed, solutions can be implemented and locals will start experiencing the benefits of accessing quality healthcare (Rural Health Information Hub, 2023). One of the barriers addressed is poor transportation. If this is handled, there will be better roads in the rural areas and this implies that it will be easier for locals to reach healthcare facilities for them to be treated for different needs. Healthcare is a basic need that everyone is entitled to. With proper access to healthcare, people will live healthier lives and life expectancy will also be increased (US Government Accountability Office, 2023). When people are healthy, they will have time to focus on other aspects of their lives that enable them to live happily. The government and other stakeholders must put their efforts together to ensure healthcare is accessible in rural areas (CDC, 2023).

References

AAMC. (2017). Health disparities affect millions in rural U.S. communities. Retrieved from https://www.aamc.org/news/health-disparities-affect-millions-rural-us-communities

Advent Health University (2022). How to improve healthcare in rural areas. Retrieved from https://www.ahu.edu/blog/improve-healthcare-in-rural-areas

Bergum, A. & Catlin, B. (2016). What works? Strategies to improve rural health. Retrieved from https://www.countyhealthrankings.org/reports/what-works-strategies-improve-rural-health

Bowling, A. (2023). Research methods in health: Investigating health and health services. Open University Press.

CDC. (2023). About rural health. Retrieved from https://www.cdc.gov/ruralhealth/about.html

Charalambous, P. (2023). Less staff, longer delays, and fewer options: Rural America confronts a healthcare crisis. Retrieved from https://abcnews.go.com/Health/staff-longer-delays-fewer-options-rural-america-confronts/story?id=97911613

CMS. (2022). Rural health strategy. Retrieved from https://www.cms.gov/files/document/rural-strat-guide-08-may.pdf

Federal Emergency Management Agency. (2022). The rural fire problem in the United States. Retrieved from https://www.usfa.fema.gov/downloads/pdf/statistics/rural.pdf

Griffiths, F. (2009). Research Methods for Healthcare Practice. Los Angeles: SAGE.

Harvard University (2019). Poll: Financial insecurity and limited access to health care plague many rural Americans. Retrieved from https://www.hsph.harvard.edu/news/hsph-in-the-news/poll-financial-insecurity-and-limited-access-to-health-care-plague-many-rural-americans/

HRSA (2022). Rural access to healthcare services request for information. Retrieved from https://www.hrsa.gov/rural-health/rfi-rural-health-care-access

Mayo Clinic (2022). Telehealth: Technology meets healthcare. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878#:~:text=What%20is%20telehealth%3F,technology%20you%20use%20from%20home .

NCSL (2020). Improving rural health: State policy options for increasing access to healthcare. Retrieved from https://www.ncsl.org/health/improving-rural-health

PhRMA. (2022). Addressing health disparities – Addressing barriers in health. Retrieved from https://phrma.org/equity?utm_campaign=2023-q2-equ-acc&utm_medium=pai_srh_cpc-ggl-adf&utm_source=ggl&utm_content=clk-pat-tpv_scl-geo_std-usa-all-pai_srh_cpc-ggl-adf-EquityEvergreenSearchWCDCKeyStatesMemberCo2-pra_equ-edu-inf-lrm-soc_txt-std-vrb-adf&utm_term=&gclid=Cj0KCQjw8NilBhDOARIsAHzpbLD_iy8DNZDGQv_622Qw48OgVFy79se3wPj1a–2uRnhwg7SynBEUWEaAoYaEALw_wcB

Regis College. (2023). Improving access to rural healthcare. Retrieved from https://online.regiscollege.edu/blog/rural-health-care/

Rural Health Information Hub. (2022). Health access in rural Communities. Retrieved from https://www.ruralhealthinfo.org/topics/healthcare-access

Rural Health Information Hub. (2023). Families USA. Retrieved from https://www.ruralhealthinfo.org/organizations/968

Rushton, S. & Youde, J. (2017). Routledge Handbook of global health security. Routledge.

Samuels, K., McClellan, M., Patel, K., & Darling, M. (2014). Transforming rural healthcare: High-quality, sustainable access to quality care. Retrieved from https://www.brookings.edu/articles/transforming-rural-health-care-high-quality-sustainable-access-to-specialty-care/

Singh, G. & Siahpush, M. (2013). Widening rural-urban disparities in life expectancy, U.S., 1969-2009. American Journal of Preventive Medicine, 46(2): 19-29.

Strasser, R. (2003). Rural health around the world: Challenges and solutions. Family Practice, 20(4): 457-463.

Tulane University School of Public Health and Tropical Medicine. (2023). How to improve healthcare in rural areas. Retrieved from https://publichealth.tulane.edu/blog/how-to-improve-health-care-in-rural-areas/

United Nations (2015). New UN report finds bulk of world’s rural populations excluded from healthcare access. Retrieved from https://www.un.org/sustainabledevelopment/blog/2015/04/new-un-report-finds-bulk-of-worlds-rural-populations-excluded-from-healthcare-access/#:~:text=The%20ILO's%20findings%20%E2%80%93%20published%20in,cent%20of%20rural%20inhabitants%20are

US Government Accountability Office. (2023). Why healthcare is harder to access in rural America. Retrieved from https://www.gao.gov/blog/why-health-care-harder-access-rural-america

Waldrop, T. & Gee, E. (2022). How states can expand healthcare access in rural communities. Retrieved from https://www.americanprogress.org/article/how-states-can-expand-health-care-access-in-rural-communities/