MARKET FORCES & RURAL HEALTH--SYSTEM & CONSUMER IMPACT

市场力量影响美国所有农村地区的速度较慢，但存在差异 在与乡村和地区的衡量标准相关的变化速度上 国家。随着这些变化的发生，两个重要的问题浮出水面： L：农村卫生保健系统将如何应对并可能参与 在，市场发生了变化？ 2.农村居民的就医行为是否会随着年增长而发生变化 农村社区的管理型医疗保健计划？ 这些问题可以在初步的基础上通过检查 已发生更改的地方的影响。每个核心问题都隐含着一系列 更具体的经验性问题。例如，第一个问题 生成以下附加问题： 洛杉机。市场变化在多大程度上源于农村制度？ lb.农村医疗服务提供者在参与医疗保健时是否发挥了很大的影响力 从城市社区运营的计划？ 基于这些问题，以下是这一行动的具体目标 项目： L：量化农户纳入管理的程度 护理计划； 2：记录参与管理保健计划与 保健服务的利用情况； 3：制定一项明智的评估，以评估以下领域发生变化的速度 农村地区，按远离大都市地区的程度分类； 4：对农村提供者的参与情况进行知情评估 和社区领袖参与正在发生的变化；以及 5：将从该项目中获得的知识直接传播给政策部门 制造者以及学者同行。

Market forces are slower to affect all of rural America, with differences in the pace of change related to measures of rurality and region of the country. As the changes occur, two important questions emerge: l. How will rural health care systems react to, and possibly participate in, market changes? 2. Will the care seeking behavior of rural residents change with growth in managed care health plans in rural communities? These questions can be answered on a preliminary basis by examining impacts where changes have occurred. Each core question implies a series of more specific empirical questions. For example, the first question generates these additional questions: la. To what extent do market changes originate with rural systems? lb. Do rural providers exercise much leverage when participating in health plans operated out of urban communities? Based on those questions, the following are the specific aims of this project: l: Quantify the extent to which rural households are enrolled in managed care plans; 2: Document linkages between participation in managed care plans and utilization of health care services; 3: Develop an informed assessment of how rapidly changes are occurring in rural areas, classified by degree of remoteness from metropolitan areas; 4: Develop an informed assessment of the involvement of rural providers and community leaders in changes that are occurring; and 5: Disseminate the knowledge gained in this project directly to policy makers as well as to scholarly peers.