Quality of Women's Care in Rural Health Clinics: A National Analysis
Most initiatives to improve the quality of health care are based on services provided in urban, high-volume inpatient centers. Little is known about the quality of health care in rural primary care settings. One type of primary care setting of interest to legislators, regulators, and the Office of Rural Health Policy are certified rural health clinics (RHCs). RHCs receive cost-based reimbursement for care of Medicare and, in most states, Medicaid populations, and are the most numerous safety net providers in rural areas. The Balanced Budget Act of 1997 requires that these sites establish quality assurance and performance improvement programs in the near future. However, a national study of quality of care in RHCs has not been completed. One indicator of quality in primary care is the measurement of the level of health screening procedures received by patients. Rural women experience higher rates of illness than urban women, yet receive fewer life-saving screening procedures. Rates of screening interventions are important in measuring the quality of women's health in RHCs and other settings.
This study will analyze the rates at which women patients receive five recommended preventive screening interventions in a national, geographically stratified random sample of RHCs. Results of the analysis will be used to derive implications for rural health policy.