Innovations in health service organization and delivery in northern rural and remote regions: a review of the literature

Int J Circumpolar Health. 2011;70(5):460-72. doi: 10.3402/ijch.v70i5.17859. Epub 2011 Oct 26.

Abstract

Objectives: To identify and review innovations relevant to improving access, quality, efficiency and/or effectiveness in the organization and delivery of health care services in rural and remote areas.

Study design: Literature review.

Methods: Key bibliographic databases that index health research were searched: MEDLINE, EMBASE and CINAHL. Other databases relevant to Arctic health were also accessed. Abstracts were assessed for relevancy and full articles were reviewed and categorized according to emergent themes.

Results: Many innovations in delivering services to rural and remote areas were identified, particularly in the public health realm. These innovations were grouped into 4 key themes: organizational structure of health services; utilization of telehealth and ehealth; medical transportation; and public health challenges.

Conclusions: Despite the challenges facing rural and remote regions, there is a distinctly positive message from this broad literature review. Evidence-based initiatives exist across a range of areas - which include operational efficiency and integration, access to care, organizational structure, public health, continuing education and workforce composition - that have the potential to positively impact health care quality and health-related outcomes.

Publication types

  • Review

MeSH terms

  • Ambulatory Care / organization & administration
  • Health Services Accessibility / organization & administration*
  • Humans
  • Medically Underserved Area*
  • Organizational Innovation
  • Primary Health Care / organization & administration*
  • Quality of Health Care / organization & administration*
  • Rural Health
  • Rural Health Services / organization & administration*
  • Rural Population / statistics & numerical data*
  • Russia / epidemiology