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Biomedical subjects

S M Cordes

Publications and source records attributed to S M Cordes.

9 recordsLinked to original sources
PubMed1994

An expert panel approach to assessing the rural implications of health care reform: the case of the Health Security Act.

The policy arena is hungry for objective information regarding the potential effects of comprehensive national and state health care reform. Such information reduces the dependence of policy-makers on information generated solely by advocacy groups and serves as a checkpoint for such information. Unfortunately, the academic community is often unable to mobilize its resources quickly enough to help meet this information need. This article describes one model for overcoming this difficulty. When the time frame is especially short, academic expertise can be brought together in the form of an expert panel. However, for such an approach to be effective, it must be carefully configured and orchestrated. Critical ingredients include much preparatory groundwork, a well-defined framework and methodology for conducting the policy analysis, and a professional facilitator. The Rural Policy Research Institute used such an approach to analyze President Clinton's Health Security Act shortly after the initial blueprint was released (but before the legislative language was released). The consensus of the expert panel was that the Health Security Act would, on balance, represent an improvement over today's rural reality. However, a number of troubling aspects were noted. First, the Act's emphasis on primary care and nonphysician providers is a double-edged sword. While these are precisely the types of providers needed in rural areas, the short-run effect may be to create increased competition for such providers from urban areas.(ABSTRACT TRUNCATED AT 250 WORDS)

Comprehensive Health Care↗
PubMed1990

Come on in, the water's just fine.

Rural America is dynamic and challenging, and it is vastly different from what it was mid-way through the century. Unfortunately, many people, including policymakers, have a very outmoded picture of what today's rural America is really like. This paper begins by exploding seven common myths about rural America. Next, three characteristics of the rural environment--diversity, sparse population, and interdependency with broader social and economic forces--are examined in relation to health care delivery and medical education. The contribution of health care to the economic needs of rural America is also explored. The paper closes by noting both altruistic and self-serving motives for the medical education establishment to become more concerned and involved in rural health issues.

Delivery of Health Care↗
PubMed1985

Biopsychosocial imperatives from the rural perspective.

Rural health issues are examined within a biopsychosocial framework by addressing three questions: what is meant by 'rural'? What are rural health needs? What factors must be considered in understanding and addressing these needs? Probably the single most important characteristic distinguishing rural from urban areas is low population density. This factor is particularly important in terms of its impact on (1) communication and transportation patterns, (2) one's 'sense of community' and (3) the availability of specialized services and complex organizations and institutions. For statistical purposes two different definitional dichotomies exist: rural-urban and metropolitan-nonmetropolitan. Although the rural and nonmetropolitan populations are not conterminous, approximately the same percentage of the nation's population is included in each of the two categories. A serious misconception is that of equating agriculture with rurality. While most farmers live and work in rural areas only a small fraction of rural Americans are engaged in agriculture. In terms of health needs, infant mortality tends to be higher in nonmetropolitan than in metropolitan areas; and limitation of activity due to chronic conditions is more likely to occur among the nonmetropolitan than the metropolitan population. Similarly, the percent of people who perceive their health as either 'fair' or 'poor' is higher for the nonmetropolitan population. On the other hand, the incidence of acute conditions and disability days per person per year are lower for the nonmetropolitan population than for the metropolitan population. Limited data on mental health suggest that the halcyon picture of country life may be grossly distorted. Understanding and addressing rural health needs involves a close look at the social, economic and medical systems operating in rural America.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude to Health↗
PubMed1978

Factors influencing the location of rural general practitioners. A study in Washington state.

Data on (1) personal background, (2) place of medical education and training, (3) reasons for selecting the present place of practice and (4) previous practice location were gathered and analyzed from 41 general practitioners in rural Washington state. The analysis was done to isolate factors influencing the choice of location by physicians. Results show that most of the physicians had spent at least some of their preadulthood years in small communities and that most had some exposure to the state of Washington before establishing their practices in the state. In addition to the apparent importance of previous exposure to small communities and Washington state, the physicians were also influenced in their locational choice by (1) the professional advantages or appeal of the community, (2) recruitment efforts by persons within the community and (3) economic reasons. The physicians were rather immobile. Most had never practiced in another community and only two of the 41 physicians planned to move to another community.

Economics↗
PubMedDate not supplied

Opinions of rural physicians about their practices, community medical needs, and rural medical care.

In a study in the State of Washington during 1971-73, 41 general practitioners in rural areas were asked their opinions about (a) their present practices, (b) the medical care needs of their communities, and (c) rural medical care in general. The most frequently mentioned enjoyable aspects of their practices were the variety and challange of medical problems confronted, the favorable working conditions of the practices, and the types of communities in which the practices were located. The most frequently mentioned sources of frustration to the physicians were the "excess work, responsibility, demands and expectations by patients and community." The physicians were more reluctant to criticize the care received by the residents of their communities than they were to criticize the care that patients received in other rural areas. Suggestions made by the physicians for improving medical care in rural Washington focused on ways to increase the number of resources used to produce medical care, rather than on structural changes in the way medical care is organized, delivered, and financed.

Attitude of Health Personnel↗