For many years, many rural hospitals have really struggled to stay viable financially in a market that is marked by a reducing patient intensity and dwindling revenues. As a result many of these hospitals are forced to close down their services with in a few years. Consequently, patients from rural areas are forced to seek medical care from richer urban medical centers. This may create a great urban-rurak divide and cause an imbalance in the quality pf basic health services that are offered in rural areas. Eventually rural people may have a larger access problem to highly sophisticated urban hospitals. Older patients may not be fit enough to travel to a large distance to an urban hospital.
Recent policy decisions have broadened support for the development of rural health networks with formal agreements for patient referral and transfer. Studies indicate that many of the patients, including old patients and women tend to bypass their local medical facility to migrate to rural medical center for specialized treatment. However women tend to admit themselves in a local health facility than men. Older patients have a strong preference for a distant hospital. Other than proximity or the location, patients exhibit strong preferences for hospitals with more beds, teaching hospitals, and those with more expertise.
More extensive studies found out some startling facts and these facts are given below:
- Patients are expected to prefer larger and more sophisticated hospitals.
- The majority of hospitalized aged rural Medicare beneficiaries were admitted to their "closest rural hospital" alternative. The remaining admissions were roughly equally split among "other rural hospital", "urban teaching hospital", and "other urban hospital” alternatives.
- There is a strong negative relationship between distance and the choice of a hospital type.
- The results also indicate that older rural patients seeking hospital care are less likely to bypass the closest rural hospital than their younger counterparts.
- The chances of bypassing the nearest rural hospital correlates with the functional disability level of patients.
- When there is a paucity of a qualified physician in a rural hospital, then are more migrations observed.
Finally, rural aged beneficiaries were more likely to avoid their closest rural hospital for in patient care, if they did not get regular medical care, did not have a stable patient-physician relationship, dissatisfied with the present health care, and had a longer transit time to their doctor's clinic. The immediate availability and accessibility of local doctors appear to influence patients' mind, and may indirectly change the financial status of rural hospitals. Most of the losses that are incurred by the local hospitals could be curtailed if they are supported by a properly planned budgetary allocation, apart from establishing an efficient medical care facility. Suggested remedies are proper allocations of funding to rural hospitals, appointment of well qualified physicians, EKG machanies, better amenities, better infrastructure, assured supply of medicines and well appointed rooms.
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