Developing Rural Health Networks Under the EACH/RPCH Program: Interim Report ofthe Evaluation of the Essential Access Community Hospital/Rural Primary Care Hospital Program

摘要

This report documents the initial development of the Essential Access CommunityHospital (EACH) program, a Federal-State initiative to maintain access to health care services in rural areas through rural health planning, the development of rural health networks and alternative provider models, and the integration of health care services. The evaluation is based on qualitative and quantitative analysis of background information provided by program grantees, secondary data from Health Care Financing Administration files, and site visits by evaluation team members. The report presents information on program development at both the State and local level. State level findings include: States have made uneven progress in program development; program planning and network development is difficult, labor intensive, and time consuming; and the program has been a catalyst for development of broader network concepts. Local level findings include: hospital commitment to the Rural Primary Care Hospital Program (RPCH) conversion is currently weak; financial stress is a critical factor, but not the only impetus for RPCH conversion; distinct RPCH models are being developed; networks are shaped by competitive relationships and local circumstances; and physicians play a critical role in facility participation.