Trends in Rural Child Healthcare: Results from 2007 National Rural Pediatrician Survey

Background

The AAP Council on Community Pediatrics (COCP) Rural Health Special Interest Group (RH SIG) has fielded a survey assessing current rural pediatricians' needs and opportunities. We suspect rural cultural, population, and provider demographics have changed. We anticipate electronic communication/telemedicine will play an increasingly important role; regional rural pediatrician meetings will be better attended than national CME; and innovative collaboration will need to occur locally with family practice and regionally with tertiary care referral centers. Today's rural pediatrician will need to be a consultant with training and comfort level in a broader range of medical and public health skills. Information from this survey will help the AAP address the disparities that exist in rural child healthcare in the US.

Objective

The objective of the survey is to analyze attitudes of rural pediatricians towards job satisfaction, training needs, ongoing CME, innovations in rural pediatric practice system support, community health linkages, and consultative support needs. Results will help the AAP to better define changing trends in both rural child health status and healthcare in the rural US and the demographics and needs of rural pediatricians.

Design/Methods

Data was collected using a 43-question survey asking about demographics, practice characteristics, access barriers, health issues, job satisfaction, pediatric training, call coverage, consultation and practice management issues, use of telemedicine, and rural CME. Survey question categories were similar to the previous AAP Rural Pediatrician Survey from 1998 so that comparative trends could be identified. Participants were identified based on their primary zip code in the AAP database.

A hard copy survey was mailed to 3,853 AAP members with rural zip codes. A second follow-up hard copy survey was mailed to 2,717 non-responders. A third online survey was emailed to 1,757 non-responders.

Results & Conclusions

Our raw response rate is 47.5%. Early data show that rural pediatricians are very satisfied or somewhat satisfied with rural practice, but have concerns with access to subspecialist care, availability of qualified staff, adequate reimbursement, and isolation. It also shows that rural pediatricians like the autonomy and independence of their practice, close relationships they are able to develop with patients and families, and managing a variety of conditions. Rural pediatricians are expressing an interest in training on the topics of mental health and obesity, which corresponds to their responses about the top health issues facing the children in their community.

Conclusions will be available by the APHA meeting in 2008.