New Solutions To Help Provide Health Care To Rural Populations

A growing need for health care services by rural residents who are generally older than urban residents, coupled with decreased federal funding for programs and fewer qualified health care providers, will lead to changes in the way health care is delivered, says Dr. Sara Barger, dean of UA’s Capstone College of Nursing.

These changes will include strategic use of case managers and a greater reliance on technology for the management of care. Barger further predicts a greater emphasis on the use of case management professionals. “If we have case managers who work with patients to obtain early access to appropriate health care services, patients will be more satisfied with their care and have better outcomes,” said Barger. “Further, we need more primary care clinics in rural areas to diagnose and treat patients for less serious illnesses or injuries, which otherwise would require a costly trip to the hospital.”

“We are now looking at one of the worst nursing shortages this country has ever faced,” Barger said. “Since these shortages will be even more severe in rural areas, nurses will need to use tele-health technology to expand the services they are capable of delivering. At the same time, the consequences of federal cutbacks mandated by the 1997 Balanced Budget Act will be more severe in 2001. Unless Congress fixes the problems that have arisen from the 1997 Act, we can expect more closures of rural hospitals, less home health services, and no payment for tele-health services.”

Barger said technology would have to be a part of any viable solution. “Obviously, making technology services more accessible and user friendly will require a financial commitment on the part of government and private business,” she said. “But the eventual benefits to patients and health care providers will far outweigh the price and compensate, at least in part, for a shortage of nurses.”

According to Dr. Jeri Dunkin, professor in the Capstone College of Nursing, tele-health technology will be vital to patients in their homes, without them having to enter a health care facility. She says the use of these services and others like them will be invaluable. For example, pregnant women who are at risk can be monitored at home without an expensive hospital stay. Also, people with asthma can have their pulmonary (lung) status monitored at home, avoiding emergency room visits. “The use of tele-health services has already been established as cost effective, and there is a renewed interest in this technology as a means of addressing the issues of access, cost and quality that continue to plague our health care system,” she said.