The Availability of Health Care Resources for Elders Living in Nonmetropolitan Persistent Low-Income Counties in the South

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Abstract
The purpose of this study was to determine if elders living in nonmetropolitan persistent low-income counties in the South had the same volume of health care resources available to them as did their counterparts who lived in other counties of the same size either inside or outside the region. Nine indicators of the availability of health care resources were examined: five reflected the availability of key health care personnel (i.e., physicians and nurses) and four measured the bed capacity of two types of health care facilities (i.e., hospitals and nursing homes). Results indicated that in 47 of 54 comparisons (87.0%), nonmetropolitan persistent low-income counties in the South had fewer health care resources available for their elderly residents than did other places the same size inside or outside the region. The largest discrepancies occurred in the availability of medical specialists, but substantial differences also were observed in the availability of the total number of physicians, physicians practicing family medicine, nurses, and the bed capacity of both hospitals and nursing homes. Three actions to improve the availability of health care resources for elders who reside in these economically depressed settings are discussed: create state-based incentives to attract health care providers to practice in such places; increase the capacity for local health planning; and, define and implement a linked system of tiered services for older persons.