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Abstract
Over the past decade national policymakers have grappled with the increasingly difficult
issue of implementing programs which sustain the viability of the rural health care system.
The set of problems that are of major concern to these decisionmakers include: (1) the shifts
in the utilization patterns away from the rural health care delivery system; (2) the impact of
modification in the health care reimbursement system which disproportionately favors urban
health systems; and, (3) the continuing difficulty in affecting the disproportionate supply of
health providers in urban areas compared to rural settings.
The complex nature of health services research demands a multidisciplinary approach
especially on sociocultural problems such as rural health delivery. Effective analysis in health
care crosses many disciplinary boundaries such as medicine, nutrition, economics, sociology,
and public health among others disciplines. A major concern to many of these rural health
research analysts is the ad hoc treatment of the rural populace in federal and state health
policy decisionmaking. The key to understanding the variance in treatment of rural health
can be appreciated by reviewing the accuracy of rural definitions.
In the present study, a refined rural definition is proposed which will assist research
analysts in providing greater information on the distribution of rural health care services. A
preliminary analysis of the proposed definitions indicates that a more precise measurement of
rural provides greater accuracy in determining the medical needs of rural areas.
Adaptation of the concept will benefit the decisionmaking process through improvements
in the methodological approach to rural health research. State legislators, regional and state
planning agencies, federal funding agencies, foundations, and other programs involved in
support of rural life program will be better able to assess the impact of programs through use
of the new definition. Finally, a refined typology for rural will also effect other research
endeavors and appears to be generalizable to research on other pertinent rural delivery issues
such as transportation, education, and regional planning.