MARKET FORCES & RURAL HEALTH--SYSTEM & CONSUMER IMPACT

市场力量影响美国农村的速度较慢， 在与农村和区域措施有关的变化速度方面， 国家随着变化的发生，两个重要的问题出现了： L.农村卫生保健系统将如何应对，并可能参与 在市场变化？ 2.农村居民的就医行为是否会随着年龄的增长而发生变化 农村社区的管理式保健计划？ 这些问题可以通过检查 发生变化的影响。每一个核心问题都意味着一系列 更具体的实证问题。例如，第一个问题 生成这些附加问题： 路易斯安那州市场变化在多大程度上源于农村制度？ lb.农村提供者在参与卫生保健时是否发挥了很大的影响力 在城市社区之外运作的计划？ 基于这些问题，以下是这一举措的具体目标 项目名称： l：量化农村家庭在多大程度上参加管理的 护理计划; 2：记录参与管理式护理计划与 利用保健服务; 3：对下列领域发生变化的速度进行知情评估： 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 和社区领导人在正在发生的变化; 5：将在该项目中获得的知识直接传播给政策 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.