BOX 5-1Participant-Identified Challenges Facing Rural Healthcare Systems

Potential problems with a regional approach to response

  • Geographic barriers (e.g., mountains)
  • Infrastructure (e.g., lack of roads connecting areas in the region)
  • Disparities across the region in funding, weather, population density, and seasonality (i.e., seasonal influx of tourists)
  • Fear among departments that regionalization will result in something being taken from them (e.g., control, resources)

Planning and response hurdles

  • Level of staffing does not allow personnel to take time away from day-to-day responsibilities
  • Costs associated with training, lack of funding for travel to training
  • Emphasis on cost containment in health care affects surge capacity (e.g., lack of beds)
  • People working in rural healthcare and EMS wear multiple hats, cover multiple responsibilities
  • Lack of integration with emergency management and public health
  • A pervasive attitude in communities that “it is not going to happen to us” negatively impacts the ability to gather all of the stakeholders for proactive planning
  • “Defensive medicine” (costs associated with conduct of unnecessary advanced imaging or other expensive procedures on patients with minimal or vague complaints)

From: 5, Coordination and Integration Across Response Platforms

Cover of Preparedness and Response to a Rural Mass Casualty Incident
Preparedness and Response to a Rural Mass Casualty Incident: Workshop Summary.
Institute of Medicine (US) Forum on Medical and Public Health Preparedness for Catastrophic Events.
Washington (DC): National Academies Press (US); 2011.
Copyright © 2011, National Academy of Sciences.

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