Week three reseach methods. Please use to capstone as your guide.

2

Literature Review

Name

National University

COH 611

November 5, 2023

Introduction

Healthcare is a basic need that everyone is entitled to. Without proper healthcare, life will be difficult due to diseases and illnesses. It is important to make sure that everyone has access to adequate healthcare so that they can live a comfortable and healthy life. Access to healthcare is fundamental and should be addressed by all relevant stakeholders to ensure that all populations have equal chances of getting medical and general health attention whenever necessary (Quilliam, Glenister, & Erwin, 2023). Regardless of other differences between populations, they should have access to proper healthcare because this is their right and they are entitled to it.

Despite healthcare being a fundamental right of all citizens, rural communities in the United States are disadvantaged because they do not have proper access to healthcare. They face different challenges that make it difficult for them to access healthcare. For instance, facilities in the rural communities are not adequately stocked. In some cases, residents do not get the services that they need. Facilities are also too far apart and this makes it difficult for citizens to access emergency healthcare (Gizaw, Astale, & Kassie, 2022). They have to travel long distances and this makes it difficult for them to get timely attention and as a result, their situations might get worse.

This section of the paper looks at different studies that have attempted to examine the difficulties that rural communities in the United States have when accessing healthcare. It is not a new challenge; it has been there for a long time and many researchers have addressed the matter. This paper reviews different research literature to see the specific items they focused on and what they discovered. A literature review is an integral part of research because it reveals important details related to the topic of study.

Literature Review

Rural health challenges

In this article, the author looked at a significant problem affecting access to healthcare in rural communities in the United States. Despite many challenges, the article paid close attention to the lack of health care insurance. Lack of insurance coverage is one of the major challenges that rural communities face when it comes to accessing healthcare (Nielsen, D’Agostino, & Gregory, 2017). It is noted that healthcare is expensive and if a patient is not financially stable, they cannot afford proper services. The lack of health insurance in rural areas is a major factor that has affected access to healthcare. This implies that patients only get basic healthcare attention despite needing advanced or specialized care. Sensitization about healthcare insurance is low in rural areas and this limits the extent to which healthcare can be accessed.

The author focused on a relevant factor that has a significant impact. It is important to note that lack of health insurance coverage does not only affect rural communities but urban ones too. However, there is a more significant impact in rural areas because most residents do not have medical coverage. This is a relevant piece of information that will contribute to the research on the topic.

According to Bolin, Bellamy, Ferdinand, et al. (2020), rural communities in the United States continue facing the same healthcare challenges despite the many years that the Department of Health has existed. The authors pointed out several challenges that rural communities have faced for years. One of the major problems is the lack of medicine in healthcare facilities. In many cases, residents go to hospitals and other healthcare facilities hoping to get medicine but there is none; they have to be referred elsewhere to get medicine.

This is a common problem, especially in public health facilities. The article also mentions the absence of tools and equipment. In the modern world, technology has significantly advanced and this has led to the development of different tools and machinery that can be used in healthcare to offer better services. However, communities in rural areas do not have this privilege (Dassah, Aldersey, & McColl, et al., 2018). Devices such as X-ray machines that have existed for decades cannot be found in many healthcare facilities in rural areas of the United States. This article primarily looks at challenges that have not been addressed for many years. It gives relevant insights into what the research needs to pay attention to.

Coombs, Campbell, & Caringi, (2022), look at the challenges that providers face in the rural areas of the United States. They conducted a qualitative study and came up with a variety of findings. Social barriers were found to hinder the provision of healthcare in rural areas. Education was identified as a significant social factor contributing to the challenge of providing healthcare in rural communities.

The study also revealed that the socioeconomic status in rural areas is way lower than in urban centers. In other words, rural communities are poorer and this is a challenge when it comes to accessing healthcare. As much as healthcare providers are willing to offer services, the citizens cannot afford what they need. This makes providers offer limited services that might solve the health problems of the patients. The article looks at relevant issues that need attention so that the identified challenges can be solved.

In this article, Cyr, Etchin, Guthrie, et al. (2019), analyze the access to specialty healthcare in urban vs rural United States population. The study reveals that in healthcare facilities in urban centers, there is a lot of equipment and machinery that enable providers to offer the best specialty healthcare. This implies that urban populations have better access to specialty care. Similarly, there are more professionals in the urban centers. Regardless of the health condition that a patient might be suffering from, if they are in an urban center, there is a high chance that they will get a specialist who will handle their situation. Urban populations are advantaged because they have both facilities and specialists.

The article reveals a sharp contrast with the situation in rural areas. There are no equipment or specialists. When a patient needs specialty care in rural United States, they will have to be referred to a different facility or a city facility. This is because there is no equipment for advanced care. There is also a scarcity of specialized care providers. This makes it a challenge for people to access specialty care. It is a health problem in the sense that, generally, the level of health in the community will be lower in rural populations as compared to urban populations. The article suggests that relevant stakeholders in the health sector should ensure there is an overhaul in the rural areas. More resources should be provided for better access to specialty healthcare.

Douthit, Kiv, Dwolatzky, and Biswas, (2015), conducted a study about barriers to healthcare access in the United States. They majorly focused on public health because this is the most affected sector. The top barrier is the scarcity of services. This resonates with some previous studies that also identified the same challenge. There is a significantly high demand for healthcare services in the rural USA but the available resources are insufficient. This makes it difficult for residents to get the services that they need.

The article also identified poor Internet in rural areas as a barrier to access to healthcare services. The authors argue that in the modern world, the Internet is used virtually everywhere and the healthcare sector is one of the areas where the service is greatly needed. Broadband internet has not penetrated all parts of the rural areas and this makes it difficult for healthcare facilities to offer internet-based services. Without the Internet, communication is hindered. The information accessed is not sufficient. The delivery of services is negatively affected. The Internet is a critical element in healthcare because it enhances communication and access to information. Lack of Internet affects the performance of healthcare facilities and this implies that they cannot offer the best services to their patients.

Kirby and Yabroff, (2020), focused on the difference between rural and urban areas concerning accessing primary care. The authors unearthed significant differences in the two cases and explained why health situations are different. One of the important differences identified is the need by rural residents to travel long distances to access health. And despite this, there was an 18% less chance that they would get the services that they were looking for. On the contrary, urban residents travel shorter distances to get healthcare services and also have more chances of being attended to as they need.

The authors attribute the disparities between rural and urban populations’ access to healthcare to differences in resources and professionals. As stated earlier, rural areas do not receive as many resources as urban. Similarly, care providers in rural areas do not have the same skills as their urban counterparts. Urban areas are more competent and this pushes care providers to seek more knowledge and skills. In the end, the gap in access to healthcare between rural and urban residents keeps widening.

McCarthy, Moore, and Smedley, et al. (2021) note that several hospitals in rural areas have been closed for different reasons. The primary reason why hospitals in rural USA are being closed is because they are not making enough money to take care of the increasing costs of providing services. In other words, the facilities are spending more than they are making. Closing such facilities makes the problem even worse for the rural residents. The already limited access to healthcare is worsened (Nuako, Liu, & Pham, 2022). This article looks at an interesting challenge that is different from the normal. While other articles focus on barriers such as lack of insurance, low education, and challenges in transport, among others, this article is the study on the impact of the closure of healthcare facilities in rural USA.

Miller and Vasan, (2021), looked at access to healthcare in rural communities in the United States from a different perspective. They look at how inequalities in access to healthcare have led to different mortality rates. Mortality rates are higher in rural areas as compared to urban areas. Similarly, rural areas have a low life expectancy (76.7 years), while urban areas have a higher life expectancy of 79.1 years. These differences are attributed to inequalities in access to healthcare. Rural communities have lower access to quality healthcare, which is why they have higher rates of mortality and lower life expectancy. This article looks at the big picture regarding what healthcare inequalities can cause in the long run.

Conclusion

The articles have focused on significant issues concerning access to healthcare for rural communities in the United States. The general point in the reviewed studies is that there is a problem in rural areas. More studies should be carried out to pinpoint the causes of the challenges and to suggest solutions that can be implemented to improve the situation.

References

Bolin, J., Bellamy, G., Ferdinand, A. et al. (2020). Rural healthy people 2020: New decade, same challenges. Journal of Rural Health, 42(31), 326-333.

Coombs, N., Campbell. D., & Caringi, J. (2022). A qualitative study of rural healthcare providers’ views of social, cultural, and programmatic barriers to healthcare access. BMC health services research, 22(438), 340-342.

Cyr, M., Etchin, A., Guthrie, B., et al. (2019). Access to specialty healthcare in urban vs rural US populations: A systematic literature review. BMC health services research, 19(974), 400-407.

Dassah, E., Aldersey, H., & McColl, M., (2018). Factors affecting access to primary healthcare services for persons with disabilities in rural areas: A best-fit framework synthesis. Global Health Research and Policy, 3(36), 101 - 107.

Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. (2015). Exposing some important barriers to healthcare access in the rural USA. Public Health, 129(6), 611-620.

Gizaw, Z., Astale, T., & Kassie, G. (2022). What improves access to primary healthcare services in rural communities: A systematic review. BMC Primary Care, 23(313), 201 - 210.

Kirby, J. & Yabroff, K. (2020). Rural-urban differences in access to primary care: Beyond the usual source of care provider. American Journal of Preventive Medicine, 22(50), 89-96.

McCarthy, S., Moore, D., Smedley, W., (2021). Impact of rural hospital closures on healthcare access. Journal of surgical research, 78(258), 170-178.

Miller, C., & Vasan, R. (2021). The southern rural health and mortality penalty: A review of regional health inequalities in the United States. Social Science and Medicine, 21(268), 113-120.

Nielsen, M., D’Agostino, D., & Gregory, P. (2017). Addressing rural health challenges head-on. Missouri Medicine, 114(5), 363-366.

Nuako, A., Liu, J. & Pham, G. (2022). Quantifying rural disparity in healthcare utilization in the United States: Analysis of a large midwestern healthcare system. PLoS ONE, 17(2), 25 - 29.

Quilliam, C., Glenister, K., & Erwin, K. (2023). Revisiting rural healthcare access through Held’s ethics of care. Social Theory & Health, 21, 178 – 193.