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Access to Services Across a Continuum of Care for Rural Beneficiaries
National health policy and the research literature focus on separate programs to address distinct diseases and types of care and targeting of special payments to different rural health care providers and facilities. The growing interest in quality of care and outcomes could shift national policy efforts toward greater attention to quality of life instead of physical placement and categorical payment of services. The purpose of this set of research activities is to extend the policy agenda beyond addressing separate components of the delivery and financing system toward enabling a comprehensive array of services essential to the health and well being of rural residents. The analysis will include a comprehensive review of scholarly and trade literature, special reports and experienced, expert judgment directed at:
- Developing a definition of the continuum of care in medical/health system terms and applying it to rural communities;
- Broadening the continuum to include community-based, social services; and
- Developing a model that defines the elements of the continuum that can and should be delivered locally, are only available in population centers and urban areas, and that might be extended into rural areas via telemedicine, mobile or rotating clinics or other means.
Publications
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Care Across the Continuum: Access to Health Care Services in Rural America
Author(s): Keith J. Mueller, A. Clinton MacKinney
Report Number: Working Policy Paper P2003-10
Date: 12 / 2003
Proposes that a continuum of care serve as the framework with which to consider rural health care policies, focusing on people and on places where people live rather than on the wants of providers and constituencies. The continuum of care describes the breadth of health care services in seven stages, from personal behavior to palliative care. The framework helps establish which health care services should be provided locally and which provided at a distance, emphasizing seamless linkages between all stages of the continuum.
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Care Across the Continuum: Access to Health Care Services in Rural America
Author(s): Keith J. Mueller, A. Clinton MacKinney
Citation: Journal of Rural Health, 22(1), 43-49
Date: 2006
Proposes a continuum of care that serves as a framework with which to assess public and private policies designed to ensure that rural residents receive appropriate health care services, in a timely manner, and in a place that optimizes care effectiveness. Community leaders and policymakers can use this health care continuum as a design framework to help reduce system complexity and implement a patient- and community-focused, rather than provider-focused, health care system. The article is divided into 3 sections: 1) basic principles that determine services to be included in the continuum and how success in providing those services is judged; 2) definition of the continuum and its basic stages based on the health systems research literature; 3) applications of the continuum and policy implications of the framework.
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