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Keywords

Rural Idaho, Idaho, Great Plains, Healthcare, Rural Definitions, Geographic Access, Disparity, Health, GIS, Tertiary Healthcare

Abstract

This paper examines the geographic accessibility of tertiary health services for the rural population of Idaho. Utilizing the two most commonly used rurality definitions, we determined the spatial distribution of the rural and urban residents in Idaho. The distance to each of the tertiary healthcare facility was calculated using Geographic Information Systems (GIS). Our analysis showed a large disparity between rural and urban geographic access to tertiary healthcare and revealed that there are significant variations in the disparity depending on the rural definition used. Thus there is a need to deploy strategies to enhance rural access and to construct rurality measures that capture the local heterogeneity, given that rurality designations impact the interpretation of access problems, and the funding eligibility for healthcare programs.

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

References

1. Gulliford. M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R., Hudson, M. (2002). What does access to health care mean? Journal of Health Services Research & Policy, 7, 186–188.
http://dx.doi.org/10.1258/135581902760082517

2. Jordan, H., Roderick, P., Martin, D. and Barnett, S. (2004). Distance, rurality and the need for care: access to health services in South West England. International Journal of Health Geographics, 3, 21.
http://dx.doi.org/10.1186/1476-072X-3-21
PMid:15456514 PMCid:524184

3. Council on Graduate Medical Education, U.S. Dept. of Health and Human Services. (1998). Council on Graduate Medical Education (COGME) tenth report: physician distribution and healthcare challenges in rural and inner-city areas. http://www.cogme.gov/10.pdf.

4. Penchansky, R., Thomas, J.W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical Care, 19, 127-140.
http://dx.doi.org/10.1097/00005650-198102000-00001
PMid:7206846

5. Guagliardo, M.F. (2004). Spatial accessibility of primary care: concepts, methods and challenges. International Journal of Health Geographics 3, 3. http://www.ij-healthgeographics.com/content/3/1/3.
http://dx.doi.org/10.1186/1476-072X-3-3
PMid:14987337 PMCid:394340

6. U.S. Department of Health and Human Services ( 2000b). Healthy People 2010: Vol II. Objectives for Improving Health (Vol II) (2nd Ed). http://www.healthypeople.gov/Document/HTML/Volume2/23PHI.htm#_Toc491137862.

7. Census Bureau. (2006). Current Lists of Metropolitan and Micropolitan Statistical Areas and Definitions (2003-2006). http://www.census.gov/population/www/estimates/metroarea.html.

8. Salant P., and Porter, A. (2007). Profile of Rural Idaho 2005. Idaho Commerce and Labor, p. 37.

9. Census Bureau. (2007). State Rankings- Doctors per 100,000 resident population, 2004 Table 154, Statistical Abstract of the United States, 2007. http://www.census.gov/compendia/statab/ranks/rank18.htm.

10. Salant P., and Porter, A. (2007). Profile of Rural Idaho 2005. Idaho Commerce and Labor, p. 37.

11. Muth, P., Duke, R., Emmons, M., et al. (2004). From Rural to Remote America, Family Healthcare in Alaska, Idaho, Oregon and Washington. Association of Maternal and Child Health Programs http://amchp.org/aboutamchp/pubs-amchp.htm.

12. Muth, P., Duke, R., Emmons, M., et al. (2004). From Rural to Remote America, Family Healthcare in Alaska, Idaho, Oregon and Washington. Association of Maternal and Child Health Programs http://amchp.org/aboutamchp/pubs-amchp.htm.

13. Chan, L., Hart, G., Goodman, D.C. (2006). Geographic Access to Health Care for Rural Medicare Beneficiaries. The Journal of Rural Health, 22(2), 140–146.
http://dx.doi.org/10.1111/j.1748-0361.2006.00022.x
PMid:16606425

14. Brustrom, J.E. and Hunter, D.C. (2001). Going the distance: How far will women travel to undergo free mammography. Military Medicine, 166(4), 347-349.

15. Haynes, R., Bentham, G., Lovett, A., Gale, S. (1999). Effects of distances to hospital and GP surgery on hospital inpatient episodes, controlling for needs and provision. Social Science & Medicine, 49(3), 425–433.
http://dx.doi.org/10.1016/S0277-9536(99)00149-5

16. Jones, A.P., Bentham, G., Harrison, B.D., Jarvis, D., Badminton, R.M., Wareham, N.J. (1998). Accessibility and health service utilization for asthma in Norfolk, England. Journal of Public Health Medicine, 20, 312–317.
http://dx.doi.org/10.1093/oxfordjournals.pubmed.a024774

17. Gesler, W.M.,and Meade, M. (1998). Locational and population factors in health care-seeking behavior in Savannah, Georgia. Health Services Research, 23(3), 443-462.

18. McCarthy, J.F.and, Blow, F.C. (2004). Older patients with serious mental illness: sensitivity to distance barriers for outpatient care. Medical Care, 42(11), 1073-1080.
http://dx.doi.org/10.1097/00005650-200411000-00006
PMid:15586834

19. Nattinger, A.B., Kneusel, R.T., Hoffmann, R.G., Gilligan, M.A. (2001). Relationship of distance from a radiography facility and initial breast cancer treatment. Journal of the National Cancer Institute, 93, 1344–1346.
http://dx.doi.org/10.1093/jnci/93.17.1344

20. Desch, C.E., Penberthy, L., Newschaffer, C.J. et al. (1996). Factors that determine the treatment for local and regional prostate cancer. Medical Care, 34(2), 152-162.
http://dx.doi.org/10.1097/00005650-199602000-00007
PMid:8632689

21. van Dis, J. (2002). Where We Live: Health Care in Rural vs Urban America, JAMA, 287(1) (Reprinted), 108-109.

22. Jones, A.P, and Bentham, G. (1997). Health service accessibility and deaths from asthma in 401 local authority districts in England and Wales, 1988–92. Thorax, 52, 218–222.
http://dx.doi.org/10.1136/thx.52.3.218
PMid:9093335 PMCid:1758521

23. Fortney, J., Rost, K., Zhang, M., Warren, J. (1999). The impact of geographic accessibility on the intensity and quality of depression treatment. Medical Care, 37, 884–893.
http://dx.doi.org/10.1097/00005650-199909000-00005
PMid:10493467

24. Chan, L., Hart, G., Goodman, D.C. (2006). Geographic Access to Health Care for Rural Medicare Beneficiaries. The Journal of Rural Health, 22(2), 140–146.
http://dx.doi.org/10.1111/j.1748-0361.2006.00022.x
PMid:16606425

25. Slifkin, R. (2002). Developing policies responsive to barriers to health care among rural residents: What do we need to know? Journal of Rural Health, 18(S), 233-41.

26. Blazer, D., Landerman, L., Fillenbaum, G. (1995). Health services access and use among older adults in North Carolina: urban versus rural residents. American Journal of Public Health, 85(10), 1384-90.
http://dx.doi.org/10.2105/AJPH.85.10.1384
PMid:7573622 PMCid:1615634

27. Larson, S.L. and, Fleishman, J. (2003). Rural-urban differences in usual source of care and ambulatory service use: analyses of national data using urban influence codes. Medical Care, 41(7), Supplement:III-65-III-74.
http://dx.doi.org/10.1097/00005650-200307001-00008

28. U.S. Department of Health and Human Services ( 2000a) Healthy People 2010: Vol I. Understanding and Improving Health (Vol I) (2nd Ed). http://www.healthypeople.gov/Document/tableofcontents.htm#volume1.

29. Deprez, R. (2004). Physician specialty practices. Strategic survival for rural hospitals. Healthcare Financial Management, 58(1), 76-80.

30. Hewitt, M. (1989). Defining “rural” areas: impact on healthcare policy and research. Congress of the United States Office of Technology Assessment. http://www.blackvault.com/documents/ota/Ota_2/DATA/1989/8912.PDF.

31. Beedasy, J., Ramloll, R., Stamm, B. H. (2008). Terrorism. In Gary Goreham (Ed.), Encyclopedia of Rural America: The Land and People. Vol 2. (2nd ed, pp. 970-973). New York: Grey House Publishing, Inc.

32. Census Bureau. (2002). Census 2000 Urban and Rural Classification. http://www.census.gov/geo/www/ua/ua_2k.html.

33. Census Bureau. (2006). Current Lists of Metropolitan and Micropolitan Statistical Areas and Definitions (2003-2006). http://www.census.gov/population/www/estimates/metroarea.html.

34. Alabama Hospital Association. Healthcare terminology. Accessed April 10, 2009. http://www.alaha.org/resources_terms.aspx?id=1143&terms=tertiary.

35. Minnesota Department of Health. Glossary of Commonly Used Health Care Terms: Tertiary care. Accessed April 10, 2008. http://www.health.state.mn.us/clearinghouse/glossary.htm.

36. USA Managed Care Organization. Healthcare terminology Glossary. Accessed April 10, 2008. http://www.usamco.com/pdf/glossary.pdf.

37. Apparicio, P., Shearmur, R., Brochu, M., Dussault, G. (2003). The measure of distance in a social science policy context: advantages and costs of using network distances in eight Canadian metropolitan areas. Journal of Geographic Information and Decision Analysis, 7(2), 105–131.

38. Guagliardo, M.F. (2004). Spatial accessibility of primary care: concepts, methods and challenges. International Journal of Health Geographics 3, 3. http://www.ij-healthgeographics.com/content/3/1/3.

39. Williams, A.P., Schwartz, W.B., Newhouse, J.P., Bennett, B.W. (1983). How many miles to the doctor? New England Journal of Medicine, 309(16), 958-963.

40. Fortney, J., Rost, K., Warren, J. (2000). Comparing alternative methods of measuring geographic access to health services. Health Services and Outcomes Research Methodology,1(2), 173-184.

41. Phibbs, C.S., Luft, H.S. (1995). Correlation of travel time on roads versus straight line distance. Medical Care Research and Review, 52, 532-542.

42. Gesler, W.M.,and Meade, M. (1998). Locational and population factors in health care-seeking behavior in Savannah, Georgia. Health Services Research, 23(3), 443-462.

43. Brustrom, J.E. and Hunter, D.C. (2001). Going the distance: How far will women travel to undergo free mammography. Military Medicine, 166(4), 347-349.
PMid:11315478

44. Peterson, J.E. (2004, September 27-28). Letter by Congressman J. E. Peterson. Conference proceedings and recommendations for Preparing for Public Health Emergencies: Meeting the Challenges in Rural America, (p. 3), Saint Paul, Minnesota. http://www.prepare.pitt.edu/pdf/crhp_agenda.pdf.

45. Ricketts, T.C., Johnson-Webb, K.D., Randolph, R.K. (1999). Populations and places in rural America. In T. C. Ricketts III (Ed.), Rural Health in the United States (pp. 7-24). New York: Oxford University Press.

46. McLafferty, S.L. (2003). GIS and health care. In J.E. Fielding (Ed). Annual review of public health (pp. 25-42). Palo Alto, CA.
PMid:12668754

47. Lovett, A., Haynes, A., Sunnenberg, G., Gale, S. (2002). Car travel time and accessibility by bus to general practitioner services: A study using patient registers and GIS. Social Science and Medicine, 55(1), 97-111.
http://dx.doi.org/10.1016/S0277-9536(01)00212-X

48. Institute of Medicine. (2004). Quality through collaboration Social Science & Medicine: The future of rural health. Committee on the Future of Rural Health Care, Board on Healthcare Services. Washington, DC. National Academies Press. Available at: http://www.nap.edu/books/0309094399/html/. Retrieved June 2, 2005.

49. Salant P., and Porter, A. (2007). Profile of Rural Idaho 2005. Idaho Commerce and Labor, p. 37.

50. Milstein R. (1999). Telemedicine -Creating Virtual Certainty Out of Remote Possibilities. An international, comparative analysis of policy, regulatory and medico-legal obstacles and solutions. The Department of Human Services, State of Victoria, Australia. Accessed March 18 2009. http://www.dhs.vic.gov.au/ahs/archive/telemed/index.htm.

51. Davis, C. (1999). Heart link. Real-time cardiac telemedicine helps keep small Utah community hospital open. Healthcare Informatics. 16 (2), 207-209. [back]
PMid:10346437

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