Chapter 4. Data Collection, Analysis and Results
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CHAPTER 4. DATA COLLECTION, ANALYSIS, AND RESULTS
In the present chapter, I will discuss the study results based on the findings from literature review. A deep analysis of the findings will be done to present the study results. The methods and steps to identify the selected articles used in this study will be explained. The reviewed articles’ results are also presented in this chapter.
Data Collection Procedures
The systematic literature review using PRISMA model was done to investigate some of the factors that lead to poor access to healthcare among the American communities living in rural America. Since its publication more than a decade ago, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement has become the widely used reporting guideline in biomedical literature. The statement has undergone several reviews including the recent PRISMA2020, which was an updated version to include more important guidelines that guide systematic reviews in biomedical. The PRISMA Statement and its extensions are an evidence-based, minimum set of recommendations designed primarily to encourage transparent and complete reporting of SRs. This growing set of guidelines have been developed to aid authors with appropriate reporting of different knowledge synthesis methods (such as SRs, scoping reviews, and review protocols) and to ensure that all aspects of this type of research are accurately and transparently reported. Previous research has revealed that rural communities in the United States have challenges accessing proper health care. This study, therefore, focused on unearthing the reasons for the situation and providing recommendations. The study also examined how medical technology can improve healthcare access in rural areas. The study focused on a review of published literature on the topic and related subjects.
From the onset of the study, several articles were retrieved from different databases and were subjected to further scrutiny. A total of (n=77) articles were identified and selected initially. After reading the abstracts of the articles, which include article overview, results, discussion, and conclusion, (n=53) were identified but (n=13) articles were deleted from the list of identified because they did not meet the inclusion criteria. The remaining articles (
n = 40) were grouped into three; one group talked about access to care (
n = 19); the second group was all about how access can be improved (
n =11); the third group focused on access and improvement strategies (
n = 6).
(Appendix 1) and
(Appendix 2) show the article identification, selection map, and articles incorporated in the review.
General overviews of the article findings indicate that many obstacles, including demography, terrain, poor internet connection, lack of insurance coverage, and poor staffing of the health facilities, hinder healthcare access in rural America. The authors agreed that mobile health, telehealth, and telemedicine technology could help increase healthcare access in rural areas. The role of medical technology in delivering health care to people in rural areas presents an exclusive avenue where this system/s was used to address patient needs. Still, the focus of this study was access to care and eliminating barriers.
Data Analysis and Results
The titles, authors’ names, and the date of publication of the articles reviewed in this study are provided in Appendix 2. The findings of the studies indicate that lack of access to healthcare or limited access is a huge problem that the American healthcare system must address. For instance, a study that Rural Health Information Hub did. (2022) that American citizens are entitled to access at least basic healthcare services such as primary care, behavioral care, dental care, and public health services, among others. However, this is not possible in rural America, where it is estimated that more than 45% of the population has no or limited access to healthcare services. Similarly, authors of the articles that were reviewed in this study agree that access to healthcare in rural America is imperative for several reasons presented in
Table 1 below:
Importance Of Healthcare Services Access
Article In-Text Citation
Improving overall physical, mental, and social health status
(Rural Health Information Hub, 2022)
Prevention of diseases
Detection, diagnosis, and treatment of illnesses
Improving the quality of care
Avoiding preventable loss of life
(Federal Emergency Management Agency (2022)
Increasing life expectancy
(Singh & Siahpush, 2013)
Significance of health care services access
Data and findings from the studies that have focused on understanding the impacts of limited or no access to health care services in rural areas in Table 1 above show an urgent need to solve the health care problem. For instance, a study by Singh and Siahpush (2013) noted that life expectancy in rural America was 76.7 years, while in urban was 79.1 years.
The article’s authors found that telehealth is a significant solution to increase access to healthcare in rural communities in the United States. This innovative solution enables patients to receive healthcare services without necessarily meeting with providers. Telehealth is usually done online, implying that there needs to be a stable internet service on both ends (Mayo Clinic, 2022). Mobile health clinics are in place to increase access to healthcare in rural communities in the United States (Waldrop & Gee, 2022). Mobile clinics enable healthcare professionals to provide healthcare services where the patient is. In conventional healthcare, the patient visits the healthcare facility. The delivery of quality healthcare is a collective responsibility. It requires the input of different stakeholders to make it achievable. Rural communities are challenging to reach. Therefore, organizations need to play different roles in ensuring people access services.
An organization such as Families USA accesses the most rural areas in the United States and provides them with healthcare services (Tulane University School of Public Health and Tropical Medicine, 2023). The authors agreed that solutions could be implemented once the barriers have been addressed, and locals will start experiencing the benefits of accessing quality healthcare (Rural Health Information Hub, 2023). One of the barriers addressed is poor transportation. If this is handled, there will be better roads in the rural areas, which implies that it will be easier for locals to reach healthcare facilities to be treated for different needs.
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Bowling, A. (2023).
Research methods in health: Investigating health and health services. Open University Press.
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Singh, G., & Siahpush, M. (2013). Widening rural-urban disparities in life expectancy, U.S., 1969-2009.
American Journal of Preventive Medicine, 46(2), 19-29.
Strasser, R. (2003). Rural health around the world: Challenges and solutions.
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Tulane University School of Public Health and Tropical Medicine. (2023).
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United Nations (2015).
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US Government Accountability Office. (2023).
Why healthcare is harder to access in rural America. Retrieved from
Waldrop, T., & Gee, E. (2022).
How states can expand healthcare access in rural communities. American Progress Organization. Retrieved from
APPENDIX 1: ARTICLE SELCTION PROCESS
Figure 1. Study Selection Flow Diagram