Abstract:
CONTEXT:Finding providers to work in the hospitals and clinics in the small towns of the USA is a significant struggle. In the traditional model, the primary care doctor sees patients in the inpatient setting in addition to a clinic practice. In the usual hospitalist model, providers specialize to work only in the inpatient setting. ISSUES:Rural communities often lack the resources, facilities, and volume to safely adopt the usual hospitalist model, which has its own disadvantages. Small town hospitals have found several ways to find a middle ground between the two models. A provider staffing model is described that utilizes internal medicine physicians to provide inpatient and consultative outpatient care in a rural 10-bed hospital in Washington State. The hospital is located in a town with a population of about 3100, in a county with an approximate population of 70 000 people. It has a 24-hour emergency room, three primary care clinics, urgent care, X-ray, pharmacy, and laboratory capabilities. In this model, the internist on duty provides care in the inpatient unit and in the afternoon sees patients consulted from primary care providers, as well as follow-up patients from the emergency room and the inpatient setting. LESSONS LEARNED:The model potentially increases access to a higher level of care in the rural setting. It potentially provides work that for the provider is interesting, satisfying, balanced, purposeful, and appropriate to their training level. Specific norms, standards, and leadership are key to functionality, including some continued experience in a larger hospital. The model has been functioning successfully for more than 3 years. The potential cost savings over the usual hospitalist model are substantial. The model could be used in other locations and in training internal medicine physicians in the rural setting. Research in this area could include randomizing communities to this and other staffing models and following the care given and the health of the community members over time.
journal_name
Rural Remote Healthjournal_title
Rural and remote healthauthors
Bunge Pdoi
10.22605/RRH4419subject
Has Abstractpub_date
2018-08-01 00:00:00pages
4419issue
3issn
1445-6354pii
4419journal_volume
18pub_type
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journal_title:Rural and remote health
pub_type: 杂志文章
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journal_title:Rural and remote health
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journal_title:Rural and remote health
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更新日期:2010-04-01 00:00:00
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journal_title:Rural and remote health
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更新日期:2011-01-01 00:00:00
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journal_title:Rural and remote health
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journal_title:Rural and remote health
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更新日期:2008-10-01 00:00:00
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journal_title:Rural and remote health
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journal_title:Rural and remote health
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journal_title:Rural and remote health
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journal_title:Rural and remote health
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journal_title:Rural and remote health
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journal_title:Rural and remote health
pub_type: 杂志文章
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更新日期:2012-01-01 00:00:00
abstract::Domestic migrant workers were stranded far from home when India declared nationwide lockdown to combat the pandemic of novel coronavirus (COVID-19). A large number of these workers were left with no economic support, no food and in many cases nowhere to live. The pandemic posed a serious health threat to these people,...
journal_title:Rural and remote health
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journal_title:Rural and remote health
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journal_title:Rural and remote health
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journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2008-07-01 00:00:00
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journal_title:Rural and remote health
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