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Chapter 4. Data Collection, Analysis and Results

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CHAPTER 4. DATA COLLECTION, ANALYSIS, AND RESULTS

Introduction

In the present chapter, I will discuss the study results based on the findings from literature review. A deep analysis of the findings will be done to present the study results. The methods and steps to identify the selected articles used in this study will be explained. The reviewed articles’ results are also presented in this chapter.

Data Collection Procedures

The systematic literature review using PRISMA model was done to investigate some of the factors that lead to poor access to healthcare among the American communities living in rural America. Since its publication more than a decade ago, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement has become the widely used reporting guideline in biomedical literature. The statement has undergone several reviews including the recent PRISMA2020, which was an updated version to include more important guidelines that guide systematic reviews in biomedical. The PRISMA Statement and its extensions are an evidence-based, minimum set of recommendations designed primarily to encourage transparent and complete reporting of SRs. This growing set of guidelines have been developed to aid authors with appropriate reporting of different knowledge synthesis methods (such as SRs, scoping reviews, and review protocols) and to ensure that all aspects of this type of research are accurately and transparently reported. Previous research has revealed that rural communities in the United States have challenges accessing proper health care. This study, therefore, focused on unearthing the reasons for the situation and providing recommendations. The study also examined how medical technology can improve healthcare access in rural areas. The study focused on a review of published literature on the topic and related subjects.

From the onset of the study, several articles were retrieved from different databases and were subjected to further scrutiny. A total of (n=77) articles were identified and selected initially. After reading the abstracts of the articles, which include article overview, results, discussion, and conclusion, (n=53) were identified but (n=13) articles were deleted from the list of identified because they did not meet the inclusion criteria. The remaining articles (
n = 40) were grouped into three; one group talked about access to care (
n = 19); the second group was all about how access can be improved (
n =11); the third group focused on access and improvement strategies (
n = 6).
Figure 1:
(Appendix 1) and
Table 1:
(Appendix 2) show the article identification, selection map, and articles incorporated in the review.

General overviews of the article findings indicate that many obstacles, including demography, terrain, poor internet connection, lack of insurance coverage, and poor staffing of the health facilities, hinder healthcare access in rural America. The authors agreed that mobile health, telehealth, and telemedicine technology could help increase healthcare access in rural areas. The role of medical technology in delivering health care to people in rural areas presents an exclusive avenue where this system/s was used to address patient needs. Still, the focus of this study was access to care and eliminating barriers.

Data Analysis and Results

The titles, authors’ names, and the date of publication of the articles reviewed in this study are provided in Appendix 2. The findings of the studies indicate that lack of access to healthcare or limited access is a huge problem that the American healthcare system must address. For instance, a study that Rural Health Information Hub did. (2022) that American citizens are entitled to access at least basic healthcare services such as primary care, behavioral care, dental care, and public health services, among others. However, this is not possible in rural America, where it is estimated that more than 45% of the population has no or limited access to healthcare services. Similarly, authors of the articles that were reviewed in this study agree that access to healthcare in rural America is imperative for several reasons presented in
Table 1 below:

Table 1:
Significance of health care services access

Data and findings from the studies that have focused on understanding the impacts of limited or no access to health care services in rural areas in Table 1 above show an urgent need to solve the health care problem. For instance, a study by Singh and Siahpush (2013) noted that life expectancy in rural America was 76.7 years, while in urban was 79.1 years.

The article’s authors found that telehealth is a significant solution to increase access to healthcare in rural communities in the United States. This innovative solution enables patients to receive healthcare services without necessarily meeting with providers. Telehealth is usually done online, implying that there needs to be a stable internet service on both ends (Mayo Clinic, 2022). Mobile health clinics are in place to increase access to healthcare in rural communities in the United States (Waldrop & Gee, 2022). Mobile clinics enable healthcare professionals to provide healthcare services where the patient is. In conventional healthcare, the patient visits the healthcare facility. The delivery of quality healthcare is a collective responsibility. It requires the input of different stakeholders to make it achievable. Rural communities are challenging to reach. Therefore, organizations need to play different roles in ensuring people access services.

An organization such as Families USA accesses the most rural areas in the United States and provides them with healthcare services (Tulane University School of Public Health and Tropical Medicine, 2023). The authors agreed that solutions could be implemented once the barriers have been addressed, and locals will start experiencing the benefits of accessing quality healthcare (Rural Health Information Hub, 2023). One of the barriers addressed is poor transportation. If this is handled, there will be better roads in the rural areas, which implies that it will be easier for locals to reach healthcare facilities to be treated for different needs.

References

AAMC. (2017).
Health disparities affect millions in rural U.S. communities. Retrieved from
https://www.aamc.org/news/health-disparities-affect-millions-rural-us-communities

Advent Health University (2022).
How to improve healthcare in rural areas. Retrieved from
https://www.ahu.edu/blog/improve-healthcare-in-rural-areas

Bergum, A. & Catlin, B. (2016).
What works? Strategies to improve rural health. Retrieved from https://www.countyhealthrankings.org/reports/what-works-strategies-improve-rural-health

Bowling, A. (2023).
Research methods in health: Investigating health and health services. Open University Press.

CDC. (2023).
About rural health. Centers for Disease Control and Prevention Rural Health Page. Retrieved from
https://www.cdc.gov/ruralhealth/about.html

Charalambous, P. (2023).
Less staff, longer delays, and fewer options: Rural America confronts a healthcare crisis. Retrieved from
https://abcnews.go.com/Health/staff-longer-delays-fewer-options-rural-america-confronts/story?id=97911613

CMS. (2022).
Rural health strategy. Retrieved from
https://www.cms.gov/files/document/rural-strat-guide-08-may.pdf

Federal Emergency Management Agency. (2022).
The rural fire problem in the United States. Retrieved from
https://www.usfa.fema.gov/downloads/pdf/statistics/rural.pdf

Griffiths, F. (2009).
Research methods for healthcare practice. SAGE.

Harvard University (2019).
Poll: Financial insecurity and limited access to health care plague many rural Americans. Retrieved from
https://www.hsph.harvard.edu/news/hsph-in-the-news/poll-financial-insecurity-and-limited-access-to-health-care-plague-many-rural-americans/

HRSA (2022).
Rural access to healthcare services request for information. Retrieved from
https://www.hrsa.gov/rural-health/rfi-rural-health-care-access

Mayo Clinic (2022).
Telehealth: Technology meets healthcare. Retrieved from
https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878#:~:text=What%20is%20telehealth%3F,technology%20you%20use%20from%20home.

NCSL (2020).
Improving rural health: State policy options for increasing access to healthcare. Retrieved from
https://www.ncsl.org/health/improving-rural-health

PhRMA. (2022).
Addressing health disparities – Addressing barriers in health. Retrieved from
https://phrma.org/equity?utm_campaign=2023-q2-equ-acc&utm_medium=pai_srh_cpc-ggl-adf&utm_source=ggl&utm_content=clk-pat-tpv_scl-geo_std-usa-all-pai_srh_cpc-ggl-adf-EquityEvergreenSearchWCDCKeyStatesMemberCo2-pra_equ-edu-inf-lrm-soc_txt-std-vrb-adf&utm_term=&gclid=Cj0KCQjw8NilBhDOARIsAHzpbLD_iy8DNZDGQv_622Qw48OgVFy79se3wPj1a–2uRnhwg7SynBEUWEaAoYaEALw_wcB

Regis College. (2023).
Improving access to rural healthcare. Retrieved from
https://online.regiscollege.edu/blog/rural-health-care/

Rural Health Information Hub. (2022).
Health access in rural Communities. Retrieved from
https://www.ruralhealthinfo.org/topics/healthcare-access

Rural Health Information Hub. (2023).
Families USA. Retrieved from
https://www.ruralhealthinfo.org/organizations/968

Rushton, S. & Youde, J. (2017).
Routledge Handbook of global health security. Routledge.

Samuels, K., McClellan, M., Patel, K., & Darling, M. (2014).
Transforming rural healthcare: High-quality, sustainable access to quality care. Retrieved from
https://www.brookings.edu/articles/transforming-rural-health-care-high-quality-sustainable-access-to-specialty-care/

Singh, G., & Siahpush, M. (2013). Widening rural-urban disparities in life expectancy, U.S., 1969-2009.
American Journal of Preventive Medicine, 46(2), 19-29.

Strasser, R. (2003). Rural health around the world: Challenges and solutions.
Family Practice, 20(4), 457-463.

Tulane University School of Public Health and Tropical Medicine. (2023).
How to improve healthcare in rural areas. Retrieved from
https://publichealth.tulane.edu/blog/how-to-improve-health-care-in-rural-areas/

United Nations (2015).
A New U.N. report finds most of the world’s rural populations excluded from healthcare access. Retrieved from
https://www.un.org/sustainabledevelopment/blog/2015/04/new-un-report-finds-bulk-of-worlds-rural-populations-excluded-from-healthcare-access/#:~:text=The%20ILO’s%20findings%20%E2%80%93%20published%20in,cent%20of%20rural%20inhabitants%20are

US Government Accountability Office. (2023).
Why healthcare is harder to access in rural America. Retrieved from
https://www.gao.gov/blog/why-health-care-harder-access-rural-america

Waldrop, T., & Gee, E. (2022).
How states can expand healthcare access in rural communities. American Progress Organization. Retrieved from
https://www.americanprogress.org/article/how-states-can-expand-health-care-access-in-rural-communities/

APPENDIX 1: ARTICLE SELCTION PROCESS

Figure 1. Study Selection Flow Diagram

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