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

Abstract #112172

Sudha Xirasagar, PhD, Dept of Health Services Policy and Management, University of South Carolina, Arnold School of Public Health, Columbia, SC 29208, (803) 576 6093, sxirasagar@sc.edu and Michael E. Samuels, DrPH, Rural Health Policy, College of Medicine, University of Kentucky, MN-150 Chandler Medical Center, 800 Rose Street, Lexington, KY 40536-0298.

Two major safety net programs available to underserved rural communities are the Critical Access Hospital Program(CAH) and the Community Health Centers Program(CHC). There is no national information available about collaboration between these programs. Knowledge of the extent of their individual collaborations would provide a base for the development of Federal health policy that would encourage further collaboration.

No published study could be found documenting rural hospital/community health center collaborations. This study was conducted in two phases. Phase I was a case study of five CHC/rural hospital collaboration, based on their successful record, to identify elements of model partnerships that enhance the effectiveness of both partners and their ability to serve patients, particularly the rural community. Based on the site visits, an instrument was developed to survey all Critical Access Hospitals with rural CHCs located within a reasonable distance permitting collaborative relationships. This survey was designed to identify the prevalence of collaborative relationships in the US, its various elements, and perceptions of the barriers and facilitators of collaborative activities with CHCs.

Among total 891 hospitals approved as Critical Access Hospitals in the contiguous US, 386 were identified to have a rural CHC within a 60-mile radius, based on GIS mapping. The survey instrument was mailed to these 386 CAH CEOs. The final response rate was 40.4% (156 respondents).

Twenty four CAHS (15.4%) reported having a collaborative agreement with a CHC. Twenty eight (18.1%) indicated that they were not aware of a CHC within their service area. Sixty nine CAHs, (44.2%) responded with answers suggesting that they don't see any major business gains or utility relevant to their survival and enhancement of their service volume or logistics as a result of CHC collaboration. Together with the 139 CAHs that indicated they were not interested in participating in the survey, a total of 208 or 53.9% of the 386 CAHs that had a CHC within a 60-mile radius clearly do not see any benefit from associating with a CHC.

The distribution and nature of collaborations will be presented, as well as barriers and facilitators. The findings will increase awareness about CAH-CHC collaboration benefits and provide a base for federal policy to improve health care access to rural populations.

Learning Objectives:

• To create awareness of the potential of rural hospital and rural community health center collaboration
• To enable a foundation for federal policy to improve collaborative relationships between hospitals and community health centers in rural areas

Keywords: Collaboration, Rural Health Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.