Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

Rural health policy is the laws, regulations, rules, and interpretations that benefit or affect health and health care for rural populations. This paper examines how rural health policy is viewed in the broader field of public policy, discusses the role of advocacy in developing rural health policy, and suggests ways to make that advocacy more…

The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship…

Sweeping changes to the Medicare program embodied in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), including a new prescription drug benefit, changes in payment policies, and reform of the Medicare managed-care program, have major implications for rural health care. The most efficient mechanism for research to…

Faculty from 5 disciplines (health administration, nursing, psychology, social work, and special education) collaborated to develop and teach a distance-learning course designed to encourage undergraduate and graduate students to seek mental health services employment in rural areas and to provide the skills, experience, and knowledge necessary…

Medical schools have increasingly ignored underserved communities' needs. Descriptions of five demonstration programs show how community-driven approaches to medical education involve academic and rural communities, select students from underserved areas, and train learners in undeserved communities. The approach also supports underserved…

The area health education centers (AHEC) program was established in West Virginia in 1972 as a centralized consortium linking undergraduate and graduate medical and health professions training in Charleston. In 1987 the reorganized AHEC began developing rural community-based consortia that integrate rural primary care residencies with state-funded…

In the Kentucky Homeplace Project, specially trained paraprofessionals who live in medically underserved rural communities make home visits, facilitate access to health care, and provide case management and culturally appropriate prevention education for poor families. Strengths include local administration and staff and holistic and traditional…

Current efforts to address the severe and worsening shortage of rural physicians include attracting and preparing rural students for medical school, enhancing medical school curricula, and placing and retaining rural physicians. Recommendations include creating incentives for successful rural training programs, encouraging innovation in rural…

As part of its mission to increase the availability of primary care providers in rural and other underserved areas of the country, the national Area Health Education Center Program has developed new rural-focused initiatives, including expanded student experiences in underserved areas, rural-track residencies, and telehealth links to rural…