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At least 19 recordsLinked to original sources
PubMed1977

Are "medically underserved areas" medically underserved?

A comparison of medically underserved areas (MUAs) and adequately served areas (ASAs) is presented. Nonmetropolitan areas represented in the Health Interview Survey (HIS) are classified as MUAs or ASAs by the official criterion of their scores on the Index of Medical Underservice (IMU), and HIS data from the two types of areas are examined for differences. Standard metropolitan statistical areas are also compared with the nonmetropolitan MUAs and ASAs. Results show no difference between MUA and ASA residents in number of physician visits per year or proportion with at least one visit in the past year, although MUA residents reported poorer health status, used some preventive services less, and used nonsurgical hospitalization more than did ASA residents. In gereral, most MUA-ASA differences tend to be similar in size to differences between ASAs and SMSAs. An alternative to the IMU, using HIS data to identify underserved areas, is discussed.

Adolescent↗
PubMed1975

An Ontario solution to medically underserviced areas: evaluation of an ongoing program.

In 1969 a program was established to place physicians in area of Ontario deemed to be medically underserviced. The main features of the program are area designation, physician subsidies, student bursaries, community participation and physician recruitment. From 1969 to March 1973, 162 communities were designated as underserviced and 196 physicians placed. As the program became active the rate of increase of numbers of physicians practising in northern rural areas (population, less than 15 000) increased sharply, exceeding that for the entire province. Fifty-three percent of bursaried students have honoured their commitment. Seventy-five communities have built modern medical centres that have been an important factor in attracting physicians. Still unanswered are whether the physicians will stay and whether the health of the population will be improved.

Community Health Services↗
PubMed2026

Cost-effectiveness analysis of a virtually administered pain coping skills training intervention in women with breast cancer in underserved areas.

OBJECTIVES: Women with cancer who live in medically underserved areas could benefit from behavioral pain interventions, but access is limited. A randomized trial reported that a 4-session virtual program incorporating pain coping skills training (mPCST) was effective in improving pain outcomes compared to an attention-control condition. We performed a cost-effectiveness analysis of mPCST vs. control. METHODS: Data on medical resource use, therapist time, and participants' attendance at intervention sessions and time associated with travel and using a mobile app were collected. The 5-level EuroQol 5-Dimension (EQ-5D-5L), a preference-weighted measure of health-related quality of life (HRQOL), was administered at baseline, after the intervention period, and 3 and 6 months later. Medicare payments were used to value medical resource use and therapist time to deliver mPCST. Patient time was valued using the average US wage. RESULTS: Medical resource utilization was similar for both groups, but hospitalizations trended higher in the mPCST group. EQ-5D-5L preference weights were higher by an average of 0.066 (p = 0.04) with mPCST across the follow-up period, representing an incremental gain of 0.04 quality-adjusted life years (QALYs) (95% CI: 0.00-0.08). When including the base-case cost of mPCST of \$500 vs. \$0 for the control group, the incremental cost-effectiveness ratio (ICER) was \$12,725 per QALY (95% CI: 5,566-69,343). Including the value of patient time added \$303 to mPCST costs resulting in an ICER of \$20,438 per QALY (95% CI: 9,051-111,403). SIGNIFICANCE OF RESULTS: mPCST is a cost-effective program that improves HRQOL for women with cancer living in medically underserved areas.

Humans↗
PubMedDate not supplied

An innovative, rational approach to rural health care.

Parts of rural, southern Illinois, like many rural areas throughout the world, are medically underserved. An innovative, rational solution to the physician shortage in those parts of rural, southern Illinois, which may be applied to other medically underserved areas, rural or urban, is proposed in this manuscript. To attract physicians to or near medically underserved, rural areas in southern Illinois it is proposed that Primary Care and Referral Centers be set up in southern Illinois. This could be done by adding well trained general practitioners, family physicians, or general internists to the staff of each emergency center of the Total Emergency Medical Service System for (southern) Illinois that is located in or near an otherwise medically underserved, rural area of southern Illinois. These additional physicians would diagnose and treat within their capabilities all non-emergency cases coming to the primary care centers and refer non-emergency cases needing referrals. Referrals would be either for secondary or tertiary health care. The Primary Care and Referral Centers should be self-supporting from pre-paid patient fees. For almost ten years a health center like a Primary Care and Referral Center has been operating at SIU/Edwardsville.

Community Health Services↗
PubMed1988

Evaluation of Gannon-Hahnemann Program to provide family physicians for underserved area.

The Gannon-Hahnemann Family Medicine Program is a combined B.S.-M.D. program designed to provide family practitioners to northwest Pennsylvania, a medically underserved area. The first six graduating classes (1981 through 1986) of the combined six-year curriculum contained 81 students. These students completed two years of undergraduate education at Gannon University, Erie, Pennsylvania, and four years at Hahnemann University School of Medicine. The students were required to complete the clinical rotations of their final year of medical school in Erie, and one of the rotations had to be family practice. Of the 81 combined-program graduates, 24 (29.6 percent) initially selected family practice residencies, while only 5.2 percent of the regular admission Hahnemann students selected family practice. Of these 24 graduates, 13 completed family practice residencies, and six of those chose to practice in northwest Pennsylvania. Nine graduates remained in family practice training.

Curriculum↗
PubMed1989

Responding to perceived needs of the twenty-first century: a case study in curriculum design.

Mercer University School of Medicine was established in response to the shortage of primary care physicians in medically underserved Georgia. Originally patterned after the McMaster model of medical education, Mercer found it necessary to modify the three academic programs of the first 2 years of a 4-year undergraduate medical education curriculum. Since accepting students in 1982, though, it has retained many of the essential qualities of problem-based learning and those educational experiences that prepare community responsive physicians to practice in medically underserved areas.

Curriculum↗
PubMed1992

Community health centers: a resource for service and training.

The American Medical Student Association (AMSA) Foundation is assisting the U.S. Public Health Service in increasing the number of primary care physicians trained and committed to practice in medically underserved areas. In collaboration with the American Academy of Family Physicians, the Ambulatory Pediatrics Association, and the Society of General Internal Medicine, AMSA conducted an assessment of federally-funded residency programs to identify and describe their affiliations with federally-funded community and migrant health centers (C/MHCs). Of the 260 programs assessed and the 147 responses, 125 offer community-based training. Of these, 73 offer training in primary care centers and 39 offer training in federally-funded C/MHCs. Residents training in the C/MHCs have positive experiences in both personal and professional development and are frequently hired by the health centers upon graduation. Benefits realized by the affiliations include a community orientation for the residents and enhancement of service and education missions for the collaborating institutions.

Community Health Centers↗
PubMed1990

The Texas Family Practice Residency Program: a profile.

In 1977, the 65th Texas Legislature created the Texas Family Practice Residency Program to encourage the training of family physicians and to improve access to health care in medically underserved areas. During the past 12 years, the number of family practice residency programs has grown from 12 to 25, with 1,174 graduates as of September 1988. This article discusses the program's origins, administration, effectiveness, and future.

Family Practice↗
PubMed1988

Evaluation of a selective medical school admissions policy to increase the number of family physicians in rural and underserved areas.

Jefferson Medical College initiated the Physician Shortage Area Program (PSAP) in 1974; this program preferentially admits medical school applicants from rural backgrounds who intend to practice family medicine in rural and underserved areas. Evaluation of the program has shown that PSAP graduates from the classes of 1978 to 1985 have performed slightly less well than their peers (non-PSAP) during medical school, although there was no difference in attrition between the two groups. Nor did the performance of PSAP and non-PSAP graduates differ during their postgraduate training. PSAP graduates from the classes of 1978 to 1981 were almost five times as likely as non-PSAP graduates to practice family medicine (59.6 vs. 12.6 percent, P less than 0.001), three times as likely to practice in rural areas (37.8 to 42.2 percent vs. 10.0 to 11.8 percent, P less than 0.001), and two four times as likely to practice in areas where there is a physician shortage (26.7 to 40.0 percent vs. 9.2 to 11.2 percent, P less than 0.01). They were 7 to 10 times as likely as their peers to combine a career in family medicine with practice in a rural or underserved area (24.4 to 31.1 percent vs. 3.1 to 3.9 percent, P less than 0.001), thereby fulfilling the goals of the PSAP. This study concludes that the medical school admissions process can have a major influence on the specialty choice and geographic practice location of physicians, and suggests one mechanism for increasing the number of family physicians in rural and underserved areas.

Career Choice↗
PubMed1978

The black physician's assistant: problems and prospects.

This is a report on a study of the social origins, attitudes, and anticipated practice settings of black and white recruits to the physician's assistant occupation. Recruits are generally representative of the larger black and white communities in their values; however, black recruits are more likely than their white counterparts to value the status, income, and stability perceived to be associated with the occupation. At the same time, blacks are more likely to favor national health insurance and to look forward to servicing the poor. These liberal social attitudes and the finding that blacks are more likely than whites to desire to practice in ghetto areas provide some support for affirmative action policies in dealing with the health manpower needs of medically underserviced areas.

Adult↗
PubMed1975

Development of the index of medical underservice.

A mathematical model was developed to predict experts' relative assessments of scarcity of personal health services. This model provides, quickly and inexpensively, estimates of the relative assessments experts would make of any area in the country, in the form of an Index of Medical Underservice. The index is being used by the Bureau of Community Health Services in the preliminary designation of medically underserved areas for the federal HMO program.

Age Factors↗
PubMed1988

Comprehensive family practice clerkship in a minority institution.

A comprehensive family practice clerkship program at Howard University College of Medicine has been conducted since 1970. This institution is one of three predominantly black institutions offering a family practice program. The senior clerkship is mandatory and at least 20 to 25 percent of each class elect to participate in a four-to six- week family practice preceptorship. As a result of the clerkship's success, over 50 percent of the program's graduates actively practice in primary medical manpower shortage or medically underserved areas.

Black or African American↗
PubMed1977

Distribution of physicians in family practice and other medical specialties in Texas, 1969-1973: a statistical review.

This article documents distributional patterns of allopathic family practice physicians (including general practitioners) in Texas as compared with allopathic physicians in all other medical specialties in the state during the period 1969-1973, for which there are reliable data. Statistical analysis of this information shows that there was a significant difference between the growth of family practice compared to all other medical specialties in both metropolitan and nonmetropolitan counties. This study draws no conclusions that the medical needs in many of these areas are not being met, since patient travel may, to some degree, compensate for disproportionate physician distribution. There is no unanimous agreement on what constitutes an ideal ratio of physicians in any specialty to a population in so-called "medically underserved" areas.

Family Practice↗
PubMed1990

Providing medical services through school-based health programs. Council on Scientific Affairs.

Resolution 162, which was adopted at the 1987 Annual Meeting by the Board of Trustees, called on the American Medical Association to study the efficacy of school-based health clinics. Recent data show that a significant number of school-aged youth are in need of an adequate source of health care. School-based health programs constitute a promising avenue for providing health services to adolescents, particularly in medically underserved areas. Although there are insufficient data to support universal establishment of school-based health programs, small-scale studies suggest that such programs are a viable means to increase access to health care for youth.

Adolescent↗
PubMed1989

Physician supply and distribution in Georgia.

Physician supply in Georgia must be considered an urgent issue. Several important points must be recognized and addressed. The lowest physicians rates are in the more rural county population groupings. The only county population grouping with a surplus of physicians is in the over 150,000 population. The majority of physicians are concentrated in the metropolitan counties. Sixteen percent of all physicians practice in the 134 counties having less than 50,000 population. The majority of physicians are in primary care specialties. Family practice is the most dominant specialty in rural areas. By the year 2000, Georgia can expect to add 5,600 physicians due to growth. By the year 2000, Georgia can expect to lose 2,600 physicians due to retirement. Family practitioners are the most uniformly distributed of the specialties examined. They are also the specialty most needed. The average age of Georgia physicians is 46. General surgeons are in the oldest average age group (50), whereas internists are in the youngest (44). Older physicians are concentrated in the more rural areas. A significant number of all physicians are over age 55. The majority of these will be retired by the year 2000. Physicians over age 65 represent 9.2% of all physicians from the survey. In Georgia, 13.6% of all physicians were Foreign Medical School Graduates. They tend to locate their practices in medically underserved areas. The specialty choices most frequently favored by FMGs are: pediatrics, internal medicine, family practice, and obstetrics/gynecology. A total of 71.2% of all physicians accept Medicare patients; 83.8% accept Medicare patients. Ninety-two percent of all obstetricians accept obstetric patients, but this participation is threatened by problems with malpractice insurance.

Adult↗