Health needs and health services in rural America are key issues directly related to education as well as community well-being. This report examines rural America's access to basic health care services and discusses options for congressional consideration. The focus is on trends in availability of primary and acute rural health care and on factors affecting those trends. The report describes the characteristics of rural populations and health programs, the availability of rural health services and personnel, and delivery of rural maternal and infant health and mental health care services. On each subject, options for congressional action are examined. The federal government currently finances several different types of rural health care programs, and has a strong interest in health care trends. Major declines in inpatient utilization, compounded by increasing amounts of uncompensated care, have undermined the financial health of many rural hospitals, which also are faced with the outmigration of rural residents to urban areas for care. Policy reform options are presented in regard to: (1) improvement of rural health facilities; (2) availability and training of health professionals in rural areas; and (3) enhancing maternal and infant care programs and mental health care programs in rural areas. This document contains numerous charts, graphics, data tables, and appendices that present background information about the study. It also includes a 745-item bibliography and a subject index.

Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.