NHS-FPX4000_Assessment2-1

Problem Identification

Access to healthcare is a big issue for a long time. Multiple factors affect the access
to healthcare are geographic location, transportation, and provider availability, and it also affects
homeless and immigrant population.

I worked as a home care nurse for a few months and then I got a chance to visit some
patients who were living in rural areas where they did not have much access to healthcare. They
must wait a long time to get an appointment in urban areas that are already booked with their
local patients. Even for their basic appointments, they must plan for transportation. Sometimes in
an emergency, their condition can worsen because of the distance they have to travel to get to the
hospital. Homeless and immigrants also do not have access to healthcare because they do not
have transportation and insurance coverage.

These days telehealth and online appointments have helped people who were
unable to get healthcare access. Also, a lot of insurance is providing free transportation so
people can have access to healthcare. But still, for some people, it is hard for them to get digital
resources to be able to get the benefits of telehealth as they do not have resources or some of
them do not have the knowledge to use it.

Identifying Academic Peer-Reviewed Journal Articles

Databases I used to access information included PubMed, summon, and Google.  I

refined my research to scholarly and peer-reviewed journals that were published in the last five

years.  I used key phrases geographic healthcare limitations, limited healthcare access in rural

areas, healthcare access barriers, and access to healthcare in the USA.

Assessing Credibility and Relevance of Information Sources

While researching creditable sources, peer-reviewed journal articles published within 5

years were selected.  Sources searched and used were relevant to the Assignment topic and

obtained from quality databases.

Annotated Bibliography

Article 1

Ali Mwase, K. B. (2022, October 26). An evaluation of a framework for supporting Ehealth
Service Delivery in a Ugandan rural setting. HIMSS. Retrieved December 6, 2022, from
https://www.himss.org/resources/evaluation-framework-supporting-ehealth-service-
delivery-ugandam-rural-setting

In this article research was done to evaluate how effective is health in a rural area by using

three parameters- functionality, usability, and traceability.  Studies revealed it was a usable

method to find challenges in delivering services in rural areas. The quality of healthcare in the

rural areas are often limited. In these rural areas, the challenges to healthcare quality are many,

ranging from poor infrastructure, low literacy, and poverty, to inadequate monitoring of patients

with chronic or serious diseases.

Article 2

Chu, C., Cram, P., Pang, A., Stamenova, V., Tadrous, M., & Bhatia, R. S. (2021). Rural

telemedicine use before and during the COVID-19 pandemic: Repeated cross-sectional

study. Journal of Medical Internet Research, 23(4). https://doi.org/10.2196/26960

This article shows how Covid-19 has affected the increase in telemedicine. This article

used the data from January 2012 to June 2020 to compare the changes in telemedicine among

rural-urban areas. It has been a major challenge for patients in rural areas to have access of

healthcare particularly for chronic disease management.  Telemedicine helps time and cost of

traveling, and Telemedicine usage was more in older adults during the pandemic in rural areas.

Despite telemedicine’s effectiveness in a rural area, there are some other limitations that affect

access to healthcare such as the availability of devices, internet connectivity, and knowledge

about technology.

Article 3

Cyr, M. E., Etchin, A. G., Guthrie, B. J., & Benneyan, J. C. (2019). Access to Specialty
Healthcare in urban versus rural US populations: A systematic literature review. BMC
Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4815-5

This article is an attempt to find if living in urban and rural areas can put people at

A disadvantage of healthcare accessibility. It also shows that even race and ethnicity plays a

role in access to healthcare. The research was conducted from CINAHL, Medline, PubMed,

PsycInfo, and ProQuest Social Sciences databases published between January 2013 and

August 2018. This article found some more contributing factors to access to healthcare

than just rural areas such as insurance policies, government, primary care, and specialty

care, race, and ethnicity.

Article 4
Naylor, K. B., Tootoo, J., Yakusheva, O., Shipman, S. A., Bynum, J. P., & Davis, M. A. (2019).
Geographic variation in spatial accessibility of U.S. Healthcare Providers. PLOS ONE,
14(4). https://doi.org/10.1371/journal.pone.0215016

This article shows the distribution of physicians, the emergence of advanced practice

providers and demographic population shifts contributed to a variation in healthcare

access. They used a combination of medical claims, provider location, and census data to do a

study of provider accessibility. They found that Midwest had higher access to family medicine

physicians whereas Urban locations had greater access to internal specialists. Nurse practitioners

had similar access to family medicine physicians in rural areas.

Learnings from the Review of Journal Articles

There are many factors that affect the accessibility of healthcare. First, I used to think that

demographic location was only one factor affecting the accessibility of healthcare but there are

lot more that can contribute to healthcare accessibility such as insurance, specialty physicians,

race/ethnic barriers, distance to get to healthcare facilities, availability of internet and devices for

telehealth,

References

Ali Mwase, K. B. (2022, October 26). An evaluation of a framework for supporting Ehealth
Service Delivery in a Ugandan rural setting. HIMSS. Retrieved December 6, 2022, from
https://www.himss.org/resources/evaluation-framework-supporting-ehealth-service-
delivery-ugandan-rural-setting
Cyr, M. E., Etchin, A. G., Guthrie, B. J., & Benneyan, J. C. (2019). Access to Specialty
Healthcare in urban versus rural US populations: A systematic literature review. BMC
Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4815-5
Chu, C., Cram, P., Pang, A., Stamenova, V., Tadrous, M., & Bhatia, R. S. (2021). Rural
telemedicine use before and during the COVID-19 pandemic: Repeated cross-sectional
study. Journal of Medical Internet Research, 23(4). https://doi.org/10.2196/26960
Naylor, K. B., Tootoo, J., Yakusheva, O., Shipman, S. A., Bynum, J. P., & Davis, M. A. (2019).
Geographic variation in spatial accessibility of U.S. Healthcare Providers. PLOS ONE,
14(4). https://doi.org/10.1371/journal.pone.0215016