Rural and Underserved Areas: How Can We Combat the Gap in Access to Neurological and Neurosurgical Care?
Objective:
To assess effective tools that have increased access to neurological and neurosurgical care for patients living in rural and underserved regions.
Background:
Social determinants of health (SDoH) is one of the major factors influencing patient outcomes (McGibbon et. al, 2008). Access to care, one of the SDoHs, is a barrier for patients in rural and underserved areas and includes neurological and neurosurgical care. Patients with neurological conditions, including traumatic brain injury (TBI) and spinal cord injuries, experience less support while caregivers lack supplies and health information (Sutton et. al, 2019).
Design/Methods:
Research articles published after 2018 were identified using a PubMed search. Articles published prior to 2018 were excluded and systemic reviews, meta-analyses, qualitative studies, and randomized-control studies were included in this analysis. The terms medically underserved area, neurology, tools, neurosurgery, physician shortage, healthcare access, medically underserved population, and rural health were used in this search.
Results:
In addition to ongoing recruitment of medical students to train and practice in underserved/rural areas and telestroke services, mobile health applications to connect with an on-call physician have been increasing. Physician consult services have also been resourceful. Connecting clinicians serving adjacent areas and partnering with neurological foundations have also improved outcomes. Other research has proposed group collaborations with both rural clinics and college teaching hospitals, to provide technological innovation to rural areas training rural surgical staff members.
Conclusions:
Implementing technological, educational, and preventative measures has shown benefits in addressing the gap in rural and underserved areas with respect to neurosurgical and neurological care. However, there are barriers to implementing these techniques, thus future research can investigate how to diminish them.