The Emergency Department as a Potential Intervention Recruitment Venue Among Vulnerable Rural Residents

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2 Scopus citations

Abstract

Meeting the health care needs of rural residents is complicated by their substantial medical burdens that frequently outstrip patient and community resources. Nowhere is this more evident than in central Appalachia. Preventive procedures are often sacrificed as patients and providers attend to more pressing medical issues. We report the results of a pilot study designed to explore the need for and appropriateness of a potential intervention placed in an emergency department (ED), with the eventual goal of using the ED to link traditionally underserved patients to preventive services. We used a convenience sample of 49 ED patients to explore their characteristics and health needs and compare them with a sample of 120 case management clients participating in the Kentucky Homeplace Program (KHP), and a general sample of 3,165 Appalachian Kentuckians. The recruited ED patients had low socio-economic status, numerous health conditions, and several unmet health needs, including need for colorectal, cervical, and breast cancer screening. Compared to their KHP counterparts, more ED patients were uninsured. Participants in the ED and KHP groups had particularly low income, were less educated, and had less insurance coverage than an average Appalachian resident. Although case management services, including the KHP have been successful in increasing access to health care by those in need, certain segments of the population remain underserved and continue to be missed by such programs. Our study suggests the need for and appropriateness of reaching out to such underserved populations in the ED and involving them into potential interventions designed to enhance preventive health services.

Original languageEnglish
Pages (from-to)77-81
Number of pages5
JournalJournal of Primary Care & Community Health
Volume2
Issue number2
DOIs
StatePublished - Apr 2011

Bibliographical note

Funding Information:
Tarasenko Yelena N. MPH, MPA 1 Schoenberg Nancy E. PhD 1 Bennett Keisa L. MD, MPH 1 1 University of Kentucky College of Medicine, Lexington, KY Yelena N. Tarasenko, MPH, MPA, University of Kentucky College of Medicine, Medical Behavioral Science Building, Lexington, KY 40536-0086 Email: ytarasenko@uky.edu Yelena N. Tarasenko, MPH, MPA, is a third year student of the Doctor of Public Health program at the University of Kentucky College of Public Health. Nancy E. Schoenberg, PhD, is the Marion Pearsall Professor of Behavioral Science at the University of Kentucky College of Medicine. Keisa L. Bennett, MD, MPH, is an assistant professor of Family and Community Medicine at the University of Kentucky College of Medicine. 4 2011 2 2 77 81 © The Author(s) 2011 2011 The Author(s) Meeting the health care needs of rural residents is complicated by their substantial medical burdens that frequently outstrip patient and community resources. Nowhere is this more evident than in central Appalachia. Preventive procedures are often sacrificed as patients and providers attend to more pressing medical issues. We report the results of a pilot study designed to explore the need for and appropriateness of a potential intervention placed in an emergency department (ED), with the eventual goal of using the ED to link traditionally underserved patients to preventive services. We used a convenience sample of 49 ED patients to explore their characteristics and health needs and compare them with a sample of 120 case management clients participating in the Kentucky Homeplace Program (KHP), and a general sample of 3,165 Appalachian Kentuckians. The recruited ED patients had low socio-economic status, numerous health conditions, and several unmet health needs, including need for colorectal, cervical, and breast cancer screening. Compared to their KHP counterparts, more ED patients were uninsured. Participants in the ED and KHP groups had particularly low income, were less educated, and had less insurance coverage than an average Appalachian resident. Although case management services, including the KHP have been successful in increasing access to health care by those in need, certain segments of the population remain underserved and continue to be missed by such programs. Our study suggests the need for and appropriateness of reaching out to such underserved populations in the ED and involving them into potential interventions designed to enhance preventive health services. community health prevention emergency department rural population Appalachia We are grateful to Samantha Bowman, Fran Feltner, Willie Bates, Carol White, Mark Dignan, and the hospital staff and patients who were instrumental in developing and conducting this research. The author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article. This research was supported by grant funding from The National Institutes of Health/ National Cancer Institute, “Appalachian Community Cancer Network” (PI: Dignan) U01 CA114622-01.

Keywords

  • Appalachia
  • community health
  • emergency department
  • prevention
  • rural population

ASJC Scopus subject areas

  • Community and Home Care
  • Public Health, Environmental and Occupational Health

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