Access to Specialty Health Care for Rural American Indians in Two States

Autor/inn/en	Baldwin, Laura-Mae; Hollow, Walter B.; Casey, Susan; Hart, L. Gary; Larson, Eric H.; Moore, Kelly; Lewis, Ervin; Andrilla, C. Holly A.; Grossman, David C.
Titel	Access to Specialty Health Care for Rural American Indians in Two States
Quelle	In: Journal of Rural Health, 24 (2008) 3, S.269-278 (10 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2008.00168.x
Schlagwörter	Access to Health Care; American Indians; Alaska Natives; Health Services; Specialists; Mail Surveys; Rural Areas; Financial Problems; Montana; New Mexico + Suchen Sie Ihr Suchwort? American Indian; Indianer; Inuit; Health service; Gesundheitsdienst; Gesundheitswesen; Erhebungsinstrument; Rural area; Ländlicher Raum
Abstract	Context: The Indian Health Service (IHS), whose per capita expenditure for American Indian and Alaska Native (AI/AN) health services is about half that of the US civilian population, is the only source of health care funding for many rural AI/ANs. Specialty services, largely funded through contracts with outside practitioners, may be limited by low IHS funding levels. Purpose: To examine specialty service access among rural Indian populations in two states. Methods: A 31-item mail survey addressing perceived access to specialty physicians, barriers to access, and access to non-physician clinical services was sent to 106 primary care providers in rural Indian health clinics in Montana and New Mexico (overall response rate 60.4%) and 95 primary care providers in rural non-Indian clinics within 25 miles of the Indian clinics (overall response rate 57.9%). Findings: Substantial proportions of rural Indian clinic providers in both states reported fair or poor non-emergent specialty service access for their patients. Montana's rural Indian clinic providers reported poorer patient access to specialty care than rural non-Indian clinic providers, while New Mexico's rural Indian and non-Indian providers reported comparable access. Indian clinic providers in both states most frequently cited financial barriers to specialty care. Indian clinic providers reported better access to most non-physician services than non-Indian clinic providers. Conclusions: Reported limitations in specialty care access for rural Indian clinic patients appear to be influenced by financial constraints. Health care systems factors may play a role in perceived differences in specialty access between rural Indian and non-Indian clinic patients. (As Provided).
Anmerkungen	Blackwell Publishing. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8599; Fax: 781-388-8232; e-mail: customerservices@blackwellpublishing.com; Web site: http://www.blackwellpublishing.com/jnl_default.asp
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10