Shortage of Health Professionals in Rural Areas

说明(申请人提供)：在农村地区提供经过经验检验的最先进的精神卫生干预措施的持续挑战是精神卫生和一般卫生保健专业人员的短缺。许多农村地区缺乏专门的精神卫生专业人员，目前注册护士短缺的情况更加严重，预计情况将进一步恶化。更令人望而生畏的是，缺乏在提供与文化相关的护理方面接受过适当培训的提供者，以及不同少数族裔和族裔人口的少数心理健康提供者。这些专业人员的短缺可能导致缺乏护理、提供不符合标准的护理、消费者结果不佳、缺乏文化上可接受的护理，并最终对社区健康造成负面影响。利用现有数据，我们将评估拥有不同数量和混合的专业人员对公共健康和成果利用类型的影响。我们会： 1)确定包括种族、贫困和农村在内的社区特征对不同类型精神卫生专业人员可获得性的影响；2)评估现有和拟议的专业人员数量之间的关系、与文化相关的精神卫生保健需求和精神卫生保健的结果；以及3)提出更好的方法来确定精神卫生专业人员的短缺(例如，HPSA)。这项研究的产品将包括一张CD，其中包含国家、州和县的精神卫生工作人员的信息。这些数据将用于政策制定者的规划和其他研究。这项研究将提供改进的数据和改进的方法，以创建和评估精神健康短缺地区的不同定义。根据卫生资源和服务管理局的说法，超过34个联邦计划依赖于短缺指定来确定资格或作为资金参考(HRSA，2002)。这项研究将提高这些重要指定的准确性，这些指定影响到参加联邦计划的资格、国家卫生服务团的贷款偿还以及对照顾居住在这些指定地区的联邦医疗保险客户的提供者的财政激励。

DESCRIPTION (provided by applicant): An ongoing challenge to the provision of state of the science, empirically tested mental health interventions in rural areas is a shortage of mental health and general health care professionals. The lack of specialty mental health professionals in many rural areas is compounded by the current registered nurse shortage, which is predicted to worsen. More daunting is the lack of providers with adequate training in the provision of culturally relevant care as well as the small number of mental health providers of different minority race and ethnic populations. The shortages of these professionals may result in the absence of care, the provision of substandard care, poor consumer outcomes, the lack of culturally acceptable care and, ultimately, in negative health for the community. Using existing data we will evaluate the impact of having different amounts and mixes of professionals on public health and utilization types of outcomes. We will: 1) determine the influence of community characteristics including race, poverty and rurality on the availability of different types of mental health professionals; 2) evaluate the relationship between current and proposed numbers of professionals, the need for culturally relevant mental health care and the outcomes of mental health care; and 3) propose better methods for determining a shortage of mental health professionals (e.g. HPSA's). Products of the research will include a CD with information on the nation, states', and counties' mental health workforce. This data will be available for use in planning by policy-makers and for use in other research studies. The study will provide both improved data and improved methods to create and evaluate different definitions of Mental Health Shortage Areas. According to the Health Resources and Services Administration more than 34 federal programs depend on the shortage designation to determine eligibility or as a funding reference (HRSA, 2002). This study will provide improved accuracy to these important designations which influence eligibility for participation in federal programs, loan repayment for the National Health Service Corps and financial incentives to providers for caring for Medicare clients residing in these designated areas.