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At least 19 recordsLinked to original sources

A controlled trial of the impact of the family practice nurse on volume, quality, and cost of rural health services.

Rural Newfoundland communities with and without expanded role nurses were compared on a before and after basis. The rural communities are located in a geographically isolated area served by a 40-bed hospital staffed by salaried physicians. Primary care visits within the community increased by 186 per cent after establishment of the family practice nurse community clinic and attendance at the hospital decreased by 35 per cent. Acute care days in hospital decreased 5 per cent in the experimental group and increased by 39 per cent in the control group. A major portion of the community based visits provided to the experimental group were classed as preventive. The total annual health service cost per 1,000 persons in the experimental group increased slightly more than in the control group (26 versus 21 per cent). Adequate management of certain indicator conditions and drugs was maintained by the family practice nurse when compared to the adequacy rating for the physician during the same time period.

Community Health Nursing

Development of rural health services: problems illustrated by a nonprofit, privately-based approach.

The historic development of a nonprofit organization designed to improve rural health services in Colorado is described and some of the major problems of rural health are discussed. This corporation, originally derived from four different kinds of provider organizations, has developed a comprehensive approach to improving the utilization of existing rural health resources and to the recruitment and deployment of new resources. Emphasis has been placed on community involvement, decreasing the isolation of rural physicians by linking rural practices with urban resources, centralizing supportive services and development of quality control methods. The peculiarities of the target area and the evolution of the goals and methods of the organization are described in order to facilitate the adaptation of these concepts to other areas.

Colorado

The financing and the economic efficiency of rural health services in the People's Republic of China.

This paper studies the resource allocation in the provision of health care services at the local level in the People's Republic of China. The subject of health financing and the effectiveness and cost of this medical cooperative service in the country's rural areas are evaluated. The conclusion drawn is that, with China's agricultural economic framework, the adoption of barefoot doctor services and the promotion of herbal medicine are cost-minimizing approaches that enable local political units to be financially self-supporting with regard to medical services. Based on a few samples at brigade or commune level, the results indicate that the barefoot doctor services are economically valuable. Furthermore, the sense of security and a point of entry into the health care system that the barefoot doctors can provide for lower-income peasants are by no means a minor noneconomic benefit. Some of their experiences may be useful to other developing countries.

China

Rural health and the role of occupational therapy.

Through the use of activities which are common to the rural culture, the occupational therapist may make a contribution in rural health services. Although the rural resident suffers psychiatric and physical disorders similar to his urban neighbor, the availability and accessibility of medical services are more limited. The isolation of rural life which makes it unattractive to health and other professionals also accentuates the problems of the rural patient. The rural health clinic has been one solution to the lack of medical services. It is proposed that the occupational therapist select farm activities which are common to the patient, and adapt and direct those activities so that the patient can again function in his rural environment.

Adolescent

Community mental health services in rural areas: some practical issues.

Several critical issues involved in successfully initiating and maintaining a community mental health center program in a rural setting are discussed. These include the necessity of accurately assessing the existing social, cultural, and political system, and of fitting the mental health center program into these systems as smoothly as possible; the special problems faced in maintaining confidentiality; and the importance of recognizing and dealing with the front-line pressures on professional staff that are peculiar to the rural setting. Advantages as well as disadvantages of working in a rural program are considered.

Attitude of Health Personnel