Qualitative Study on Augmenting Rural Health Care Access: The Patient Perspective

Qualitative Study on Augmenting Rural Health Care Access: The Patient Perspective

Exploration of research indicates augmentation of rural “access” to health care as the prominent reason for enhanced, societal health outcomes and health care system sustainability. The significance of addressing approaches to augment health care access in rural communities is well acknowledged. Still, minuscule changes have been completed to increase health care access in rural communities. A part of the problem is the various definitions of access, diverse approaches and policies, and continuing disparities in access within rural communities and between urban and rural counties.

The research project undertaking as a fellow in the Center for Health and Nursing Research focuses on the patients’ perspectives for viable approaches to augment health care in rural communities in Johnston County, North Carolina, integrating demand and supply-side factors enabling access to health care including the acquisition of health care through benefiting from the services. Facilitating and communicating concepts to augment health care between and within counties.

In the realm of health care, “access” is defined as: (1) access to a service, (2) access to a provider, and (3) access to an institution (Levesque, Harris, & Russell, 2013). Access is critical to the performance of health care because if all communities and ethnicities do not have access performance cannot be measured (Souliotis, Hasardzhiev, & Agapidaki, 2016). A 2016 report by the County Health Ranking & Roadmaps and the University of Wisconsin Population Health Institute investigated the differences in health between rural and urban counties exposed shocking results. Namely, the premature deaths in the rural counties have had the highest rates of premature death for several years, when compared to premature deaths in urban counties (County Health Ranking & Roadmaps and the University of Wisconsin Population Health Institute, 2016). The findings from the report along with other studies made known the manifestation of the disparities between urban and rural counties health care access (County Health Ranking & Roadmaps and the University of Wisconsin Population Health Institute, 2016; Levesque, Harris, & Russell, 2013; Rural Health Information Hub, 2018; Souliotis, et al., 2016).

In an attempt to close the gap in the disparities, there is a need to be prudent, by prioritizing, and consistently considering cultural nuances to optimize rural community’s health care access (Rural Health Information Hub, 2018). Various states, such as N.C., are supported by the Mid-Atlantic Telehealth Resource Center (MATRC). The MATRC is funded by the federal Office for the Advancement of Telehealth to support HCO, health care networks, and health care providers in the execution of economical telehealth applications to aid rural populations (Rural Health Information Hub, 2018). Additionally, to take full advantage of the prospect to address the disparities in health care, a concerted effort concentrated on environmental changes should be integrated (County Health Ranking & Roadmaps and the University of Wisconsin Population Health Institute, 2016). The Rural Health Centers Program Capital Project in N.C. was established and instigated projects intended to increase quality driven, economical care to meet the transitions mandated through Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation and other industry trends(Rural Health Information Hub, 2018).

The current study will accentuate the study completed by Johnston UNC Health Care and advance the current state of knowledge empirically. Using patients’ perspective approaches to augment health care in rural communities in Johnston County, N.C. could suggest viable augmentative approaches for access to health care in rural communities. The results will add to the body of literature on how to augment health care access in rural communities. Methodically, the study will employ qualitative a case study design to highlight strong points and misgivings on patients’ perspective of access for rural communities. The study cultivates opportunities for learning about patient perspectives in rural communities (Elsevier, n.d.). Apply to present at conferences related to rural health care access. Submit an article for publications to the venues associated to rural health. For instance, the International Journal for Equality in Health, Public Health Genomics on PubMed, the Journal of Rural Health and the National Rural Health Association (NRHA) Journal of Rural Health. Create a policy brief of the results aimed at government policymakers framing rural health care policy (Rural Health Gateway, 2017).


County Health Ranking & Roadmaps and the University of Wisconsin Population Health Institute (2016) What Works? Strategies to Improve Rural Health. Retrieved from http://www.countyhealthrankings.org/node/35670.

Elsevier. (n.d.). A guide for writing scholarly articles or reviews for the Educational Research Review. Retrieved from: https://www.elsevier.com/__data/promis_misc/edurevReviewPaperWriting.pdf.

Levesque, J.-F., Harris, M. F., & Russell, G. (2013). Patient-centered access to health care: conceptualizing access at the interface of health systems and populations. International Journal for Equity in Health, 12, 18. http://doi.org/10.1186/1475-9276-12-18.

Rural Health Gateway. (2017). Dissemination of Rural Health Research: A Toolkit. Retrieved from https://www.ruralhealthresearch.org/toolkit.

Rural Health Information Hub. ( 2018). N.C.. Retrieved from: https://www.ruralhealthinfo.org/states/north-carolina.

Souliotis K, Hasardzhiev S, & Agapidaki E. (2016). A Conceptual Framework of Mapping Access to Health Care across EU Countries: The Patient Access Initiative. Public Health Genomics, 19:153-159. https://doi.org/10.1159/000446533.



Walker Ladd's picture Walker Ladd | March 9, 2018 11:46 am MST

Dr. Ruffin,

Your work exemplifies the best of our initiative to expand the paradigm of health research to address access to health care for all. Thank you for sharing your research progress for your Fellowship!

T. Ray Ruffin's picture T. Ray Ruffin | March 10, 2018 4:06 am MST

Greetings Dr. Ladd

Thank you and to go a step further we need study dental access as well. For instance, periodontal disease can lead to health problems especially in the elderly. 

Chara Price's picture Chara Price | April 9, 2018 1:19 pm MST

What a wonderful blog!  I am an admin for this site and featured it on the homepage.  

T. Ray Ruffin's picture T. Ray Ruffin | April 12, 2018 11:44 am MST

Greetings Chara Price

Thank you so much! I am honored you felt the blog noteworthy enough to be featured on the homepage.

Deborah Fuqua's picture Deborah Fuqua | April 24, 2018 6:30 am MST

Dr. Ruffin,

Very good information, thanks for sharing. I look forward to hearing more from you.



About the Author

Dr. T. Ray Ruffin



Journal of Leadership Studies-Symposium Piece-Relational Leadership: Perspectives of Key Constructs on Diversity, Inclusion, and Social Equity in Higher Education

Psychology Today
Blog Posts Published


American Psychological Association Conference-Utilizing Clinical Hypnotherapeutic Intervention with CBT to Treat Pandemic-Aug. 13-2021 Symptomology

ILA Conference Geneva Switzerland 2021
Presenter -Topic-"The Stress Arc in Leadership and 3 Powerful Disciplines for Mitigating Major Stress Impacts in a New Era"-Upcoming
Presenter -Topic-“Improving Higher Education’s Role in Diversity and Social Equity through Relational Leadership in the New Era”-Upcoming
Presenter-Topic-"Healthcare Leadership-Using Virtuous Leadership in Chaos to Reimagine Beneficial Practices of Employee Cognitive Psychology"-Upcoming
2021-Knowledge Without Boundaries National Summit-College of Doctoral Studies Research Conference-University of Phoenix-Panel Discussion-"Exploring Emergent Trends in Leadership and Education"-Based on published symposia article from the Journal of Leadership Studies- https://onlinelibrary.wiley.com/doi/full/10.1002/jls.21734


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