Delivering Essential Health Care Services in Rural Areas: An Analysis ofAlternative Models

摘要

In many rural communities, the survival of small hospitals is in jeopardy becausethey are no longer able to meet the financial and legal requirements of a traditional full-service facility. To maintain access to essential health care services for rural residents, a number of States and communities are converting closed or failing rural hospitals into alternative kinds of health facilities. The analysis examines six such models. Three models maintain acute care inpatient beds for stabilization and holding capacity; the other three models eliminate all acute care beds. Each model uses the same basic remedies to address these problems: reduce or eliminate inpatient beds, discontinue performing costly and complicated services, cross-train personnel to perform multiple tasks, and develop referral relationships and linkages with other hospitals. The report is a revised version of a background paper commissioned for a 1990 workshop, 'Alternative Models for Delivering Essential Health Care Services in Rural Areas'.