Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106636

Louise C. Miller, PhD, RN and Constance Brooks, PhD, RN, CS. Public Health Nursing, University of Missouri-Columbia, Sinclair School of Nursing, S303 School of Nursing Building, University of Missouri, Columbia, MO 65211-4120, 573-884-9542, LMiller@missouri.edu

Consumers tell us health care needs can best be met when responsibility for health care services is “in their own backyards”. Federal and state governments often neglect the consumer perspective, resulting in programs that are ineffective in achieving improvements in access to care and local health outcomes. To better understand health needs of uninsured/underinsured Missourians, the Missouri Department of Health and Senior Services conducted a comprehensive study of availability and quality of health care services and health insurance through a HRSA-funded State Planning Grant. This paper reports one part of this study, the 15 consumer focus groups held in Missouri communities during spring, 2004. The 135 participants representing small and large, urban and rural communities reported a desire for local management of health services. In their view, strengthening primary care systems, adding to and enhancing community hospital-based services, and correcting inadequate dental care are some of the services that should be decided upon and directed locally. Participants' reasons for shifting control of health care to local communities include personal knowledge of and access to providers and systems, familiarity and trust among community members, ability to design strategies to achieve access to specialist care outside the community, and use of community talents to resolve local health care system problems. Consumers reminded grant planners that communities need and want to be involved in the process of designing solutions to improve and customize local services to meet the health care needs of community members.

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