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      Seeking Care at Free Episodic Health Care Clinics in Appalachia

      research-article
      , RN, BSN , PhD, RN, FAAN , PhD, RN, CEN
      Journal of Appalachian Health
      The University of Kentucky
      Appalachia, access to care, episodic clinics, health care, social justice

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          Abstract

          Background

          People who live in rural Appalachia experience a wide variety of problems when seeking access to health care. Health care disparities continue to be one of the most complex and prevalent problems, and many barriers exist for impoverished men and women such as a lack of education, complications with health insurance, and personal distrust of healthcare providers.

          Purpose

          A critical gap in the literature is the unheard voice of persons in rural underserved areas. The purpose of this study was to explore the perspectives of persons in rural Appalachia who seek healthcare services at free episodic health care clinics, a common alternative source of care.

          Methods

          In Fall 2017, a qualitative approach was used to discover the perceptions of 12 men and women in rural Appalachia who were seeking medical care at a Remote Area Medical Clinic. A transdisciplinary research group provided insight and assistance with thematic analysis in Spring 2018–Spring 2019.

          Results

          Five overall themes emerged capturing the essence of how rural Appalachians view the experience of seeking healthcare, which include difficulties with insurance/finances, inconsistency in care, isolation in rural areas, seeking solutions, and need to feel valued.

          Implications

          A rich description of participant experiences portrays real-life complexities for Appalachian men and women who seek healthcare. Understanding the perceptions of persons who seek healthcare and the essence of their experiences is the first step in determining future sustainable solutions for social justice.

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          Most cited references11

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          Whatever happened to qualitative description?

          The general view of descriptive research as a lower level form of inquiry has influenced some researchers conducting qualitative research to claim methods they are really not using and not to claim the method they are using: namely, qualitative description. Qualitative descriptive studies have as their goal a comprehensive summary of events in the everyday terms of those events. Researchers conducting qualitative descriptive studies stay close to their data and to the surface of words and events. Qualitative descriptive designs typically are an eclectic but reasonable combination of sampling, and data collection, analysis, and re-presentation techniques. Qualitative descriptive study is the method of choice when straight descriptions of phenomena are desired. Copyright 2000 John Wiley & Sons,
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            Barriers to Health Care Access for Low Income Families: A Review of Literature

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              Using Telehealth to Remediate Rural Mental Health and Healthcare Disparities.

              "Deaths of despair", deaths due to drugs, alcohol, and suicide, occur at higher rates in rural communities. The incidence of such deaths highlights underlying access and treatment disparities which result in poorer outcomes. Telehealth is a viable option for addressing rural mental healthcare needs as it enables more effective care management, provides expanded access to services, and fosters integrating primary and mental healthcare services. Implementing telemental health will involve overcoming coverage and reimbursement, licensure, broadband access and adequacy, and privacy and security barriers and advancing select policy changes. Telehealth diffusion will require changes in professional training and care delivery models.
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                Author and article information

                Journal
                J Appalach Health
                J Appalach Health
                Journal of Appalachian Health
                The University of Kentucky
                2641-7804
                2020
                15 April 2020
                : 2
                : 2
                : 67-79
                Affiliations
                University of Tennessee, Knoxville
                University of Tennessee, Knoxville
                University of Tennessee, Knoxville
                Article
                jah-2-2-67
                10.13023/jah.0202.07
                9138721
                35769864
                d7bf1c97-de6a-4900-9599-bd3af01a59c4
                Copyright © 2020 Malerie Lazar, Sandra Thomas, and Lisa Davenport

                This work is licensed under a Creative Commons Attribution 4.0 License.

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                appalachia,access to care,episodic clinics,health care,social justice

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