Disease Management in Rural Populations: Can It Be Done?

Rural health care providers must cope with various challenges that far exceed recognized, conventional concerns such as financing, controlling costs, and ensuring proper medical care. The provision of health care in rural populations is additionally complicated by limited number of health care providers, higher rates of uninsured, longer distances to travel for treatment, and fewer community resources to supply and support health care (Bierman and Clancy, 1999; Keefover et al., 1996; Noonan, 1997; Aadalen, 1998; Moscovice and Rosenblatt, 2000; Dalton, 2001; Welch et al., 2002; Beaulieu et al., 2003). In order to address rural access problems, federal and state health agencies have implemented a variety of programs, including Federally Qualified Health Centers (FQHCs), Critical Access Hospitals (CAHs), Rural Assistance Center (RAC), Rural Health Clinics (RHCs), and state sponsored Rural Development Councils (Kozma, 1998; Diamond, 1999; Rawlings-Sekunda et al., 2001 June; Welch et al., 2002; Foote, 2003). Despite the intent of these programs to provide and improve health care in rural locations, limited access to health care by rural populations continues as a significant concern.