Rural-Urban Health Center Assessment

Background/Introduction

Health disparities are issues widely recognized in the United States and around the World. There are many determinants and factors linked with poor quality of health and access to health care services. The lack of access to care may lead to adverse health outcomes such as: cardiovascular disease, diabetes, hypertension, cancer, mental health, early mortality, etc.  Achieving Health Equity is an undertaking sought after by The Health Resources and Services Administration (HRSA).  HRSA’s approach to attaining this goal is through providing access to quality services and improving health.  Improving access to health care services for the uninsured, isolated or medically vulnerable populations are the main foci of the agency.

Purpose

The objective of this study was to analyze and compare the clinical performances between HRSA’s federally funded urban and rural health centers. The researches sought to determine the equivalence or difference in clinical performance for health centers in rural settings and their urban counterparts, and determine what aspects show or have potential of facilitating and/or inhibiting their clinical care to their patients.

Methods

2012 Data was extracted from HRSA’s Uniform Data System (UDS) for analysis. UDS clinical data (Access to Prenatal Care, Low Birth Weight, Cervical cancer screening, Tobacco use assessment, Tobacco cessation counseling, Colorectal cancer screening, Cervical cancer screening, Blood Pressure control, and Diabetes control) were analyzed using statistical software (SAS and Excel) by conducting frequency distributions, logistical regression, and chi-square analysis to compare clinical performance between urban and rural health centers. Health Centers were categorized as being urban or rural through self-reporting. Ongoing research will include cross-tabulations to assess relationships among indicators that show or have potential of facilitating and/or inhibiting their clinical performance.

Results/Findings

Of 1198 HCs that reported to the Uniform Data System for 2012, 575 (48%) are self-identified as rural and 623 (52%) as urban.  Preliminary findings show that there is 11% and 7% clinical performance difference in access to prenatal care (urban 52%, rural 41%) and cervical cancer screenings (urban 55%, rural 48%) respectively. The remaining clinical performance areas show little to no statistical difference between rural and urban health centers.

Conclusion

Further research is needed and will effectively assist HRSA’s mission to appropriately support Health Centers. Additionally, with health centers showing low colorectal cancer screenings in rural and urban areas, it is imperative for further research to be conducted to find and implement effective evidenced based approaches/interventions.