RESUMEN
The quintessential difference between most successful rural health programs and unsuccessful ones is local leadership. The ways in which a community invites, values, develops, nurtures, and supports the involvement of diverse stakeholder groups form an important part of the base for local rural health program success. Successful programs are initiated by local stakeholder groups who are committed to collaboration, have a working governance structure, a good understanding of their health and healthcare challenges, and a plan for sustainability. A key first step for rural community health planning is to contact one's local state Office of Rural Health. Most ORHs will provide information, guidance, and technical assistance. There are many challenges in rural health, but there are also great successes. North Carolina communities fare better than many because the North Carolina Office of Rural Health has demonstrated how effective state and local leadership work together to directly benefit rural communities and rural people.
Asunto(s)
Planificación en Salud Comunitaria/organización & administración , Conducta Cooperativa , Relaciones Interinstitucionales , Liderazgo , Administración en Salud Pública , Servicios de Salud Rural/organización & administración , Participación de la Comunidad , Relaciones Comunidad-Institución , Diversidad Cultural , Toma de Decisiones en la Organización , Humanos , Inversiones en Salud , Modelos Organizacionales , North Carolina , Desarrollo de ProgramaRESUMEN
CONTEXT: Many state, federal, and foundation resources have been invested in improving the recruitment of primary care providers to rural communities. The Southern Rural Access Program of the Robert Wood Johnson Foundation (RWJF) has provided varying levels of support to several southern states to assist with retention of those providers. PURPOSE: This study describes the strategies that 6 states used to develop and implement practice management technical assistance services for rural health care providers. METHODS: Practice managers in each of the 6 states were surveyed regarding how their service was structured, what types of entities were eligible, and the nature of the technical assistance offered. Information regarding what types of entities used the service, characteristics of the practices, and the number of practices served was also collected. FINDINGS: The survey results showed that almost half (46%) of all practices assisted were private stand-alone physician practices, with overall practice assessments being the practice management service rendered most often. Although the type of organisational home for the technical assistance services varied by state, overall states employed an average of 1.67 full-time equivalent practice managers (0.81 full-time equivalent supported by RWJF) and received an average of $136,055 per state from the RWJF for the 2-year period beginning April 2002 for practice management support. CONCLUSIONS: Overall, the study found that the type of organizational home did not appear to affect the type of technical assistance services offered. However, the type of orgnizational home did appear to affect what types of providers used the service, with trade associations assisting their members or constituents at least half the time.