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Maren.
Qualified Health Centers provide community-based healthcare. The providers collect funds from the Health Resources and Services Administration (HRSA) Center Program to offer primary care in unserved areas. They have to follow strict requirements, such as providing a care sliding fee scale regarding payment abilities, ongoing quality assurance programs, and a governing board of directors. Moreover, they offer comprehensive services (on-site or by appointment), such as preventive health services, dental services, mental health, substance abuse services, transportation services, hospital, and special care. Examples are Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Health Centers for Residents of Public Housing (Health Resources & Services Administration, 2018).
In 2000, around 10 million people needed long-term care in the United States. Six million (63%) of that number were over age 65. According to the Urban Institute (n.d), “the number of Americans ages 65 and older will more than double over the next 40 years, reaching 80 million in 2040.” Long-term care can be provided at home or in a facility through different caregivers and family or relatives dependent on the patient’s needs. Long-term care facilities offer various services such as medical and personal care to patients who cannot live independently anymore. The type of care is different from short-term care since it is planned for a longer period (typically around 12 months), and it does not have a distinct outcome like treatment for an acute disease, illness, or injury. Examples of the most common long-term care facility types are: Nursing homes, assisted living facilities (ALFs), skilled nursing facilities (SNFs) and continuing care retirement communities (CCRCs) (Long-term care facility, n.d.).
Ambulatory surgery centers (ASCs) are modern healthcare organizations that offer same-day surgical care, diagnostic and preventive care. They have modernized the outpatient experience for millions of Americans by establishing a more convenient opportunity for hospital-based outpatient practices. The focus lies on the quality of care, positive patient results and experiences (Ambulatory Surgery Center Association, n.d).
A physicians practice is a medical practice involving one or more physicians organized to offer patient care. Numerous practice options are possible, each with specific pros and cons. Standard medical practice settings are, for example, a solo practice (a practice without partners that has lost popularity but is still a usual setting for some internists). Group practices are typically classified as single-specialty and multispecialty practices. In contrast to employed physician practices, which are usually solo, or group practices managed by hospitals or physicians directly hired in their facility (American College of Physicians, n.d).
The access to healthcare in many rural areas is limited. Ideally, all individuals should have access to healthcare services such as primary care, dental care, behavioral health, and emergency care. Access to healthcare services is essential for the overall physical, social, and mental health status, preventive treatments, diagnosis, quality of life, and life expectancy. However, patients in rural areas often face barriers. Even if there is a sufficient supply of healthcare services, rural patients often have difficulties with not having the appropriate insurance, transportation, health literacy, trust, or stigma (Rural Health Information Hub, n.d.).
References:
Ambulatory Surgery Center Association (ASCA). (n.d) Ambulatory surgery centers. https://www.ascassociation.org/advancingsurgicalcare/asc
American College of Physicians. (n.d). Medical practice types. https://www.acponline.org/about-acp/about-internal-medicine/career-paths/residency-career-counseling/resident-career-counseling-guidance-and-tips/medical-practice-types
Health Resources & Services Administration. (2018, May). Federally Qualified Health Centers. https://www.hrsa.gov/opa/eligibility-and-registration/health-centers/fqhc/index.html
Long-term care facility. (n.d.). Definitive Healthcare. https://www.definitivehc.com/resources/glossary/long-term-care-facility
Urban Institute. (n.d.). The US population is aging. https://www.urban.org/policy-centers/cross-center-initiatives/program-retirement-policy/projects/data-warehouse/what-future-holds/us-population-aging#:~:text=The%20US%20Population%20Is%20Aging%20%7C%20Urban%20Institute&text=The%20number%20of%20Americans%2
Rural Health Information Hub. (n.d.). Healthcare access in rural communities. https://www.ruralhealthinfo.org/topics/healthcare-access
Lisa
Vulnerable Populations: There is no defined set of factors that can determine whether a community is vulnerable, however there is a list of characteristics of vulnerable rural and urban communities, such as
· lack of access to primary care services
· poor economy, high unemployment rates, and limited economic resources
· high rates of uninsurance and underinsurance
· cultural differences that may pose challenges, such as social, cultural, and linguistic barriers that may prevent patients from accessing care
· low education or health literacy levels
· environmental challenges, which include unsafe streets; asthma exacerbated by air pollution, leading to unnecessary hospitalizations; housing instability, leading to environmental allergens causing symptoms that may result in inappropriate testing; and minimal or no spaces for physical activity or exercise (Bhatt & Bathija, 2018).
Also, certain characteristics may be unique to rural and urban communities. For example, in vulnerable rural communities a declining and aging population, the inability to attract new businesses, and business closures are seen while characteristics of vulnerable urban communities may include a lack of access to such basic needs as food, shelter, and clothing and a disproportionately high disease burden.
Homeless- have an increased risk for adverse health-related outcomes and are less likely to have a regular source of care.
Prisons- People in prisons and jails are disproportionately likely to have chronic health problems including diabetes, high blood pressure, and HIV, as well as substance use and mental health problems. Correctional healthcare is low-quality, difficult to access and expensive. Most prisons charge incarcerated people for doctor visits
LGBTQ+ - Nearly 1 in 5 members of the LGBTQ community has avoided seeking medical care because they have faced or fear facing discrimination. Discrimination is also associated with higher rates of psychiatric disorders, substance abuse, and suicide.
Disabled-Disabled individuals may have difficulty accessing care or obtaining services due to economic status and geographical locations
Immigrants- immigrants have lower rates of health insurance, use less health care, and receive lower quality of care than U.S.-born populations.
Minorities- lack of opportunity, medical ineligibility, circumstantial reasons such as lack of flexibility in childcare or employment preventing participation in research, and lack of relevant cultural understandings.
High-risk groups-
· People in rural areas often have worse health than the general population due to geographic isolation, lower socioeconomic status, limited job opportunities, and tend to be older.
· Native Americans living on reservations have lower life expectancy (5.5 years less than the all-races population) inadequate education, higher poverty rates, and cultural differences have also led to a disproportionate disease burden.
Resources
Bhatt, J., & Bathija, P. (2018). Ensuring access to quality health care in vulnerable communities. Academic Medicine, 93(9), 1271–1275. https://doi.org/10.1097/acm.0000000000002254
Initiative, P. P. (n.d.). Public health. Public health | Prison Policy Initiative. Retrieved April 14, 2022, from https://www.prisonpolicy.org/health.html
Rogers, W., & Lange, M. M. (2013). Rethinking the vulnerability of minority populations in research. American Journal of Public Health, 103(12), 2141–2146. https://doi.org/10.2105/ajph.2012.301200