Prevalence studies of the use of ambulatory health care services have consistently reported relatively lower demand for services in rural areas. Such studies have implied that low use rates may be fixed characteristics of rural populations and may be resistant to the influence of manipulable variables such as supply of physicians. This longitudinal study suggests that use rates are in fact significantly changed after improvement of manpower resources, but that the effects are limited to the vicinity of new practice locations.

Adolescent↗

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Use of medical services and satisfaction with ambulatory care among a rural Minnesota population.

Patient satisfaction with health care services and the use of ambulatory care in rural southeastern Minnesota were surveyed before and after physician manpower was increased. This report is confined to the findings in 1974, before the three local practicing physicians were joined by two additional physicians. The physician to population ratio at the time of the initial survey was 1 to 6,200 in 1974 and 1 to 2,500 with the additional physicians in 1975.In this area the population of 12,400 centered around the town of Zumbrota. A total of 1,332 persons completed questionnaires, and 796 filled out a second questionnaire concerning patient satisfaction with health care. The scores on 40 items formed 18 satisfaction indices.Use of health services was lower than in the National Health Survey of 1969; the mean number of visits per year in Zumbrota was 3.3 compared with 4.3 for the national sample. The volume of use in the Zumbrota region was low, particularly among adults. Use of services was not significantly related to the education, occupation and income of the residents. About 10 percent of the population accounted for half of the total number of visits.Only a few of the 18 patient satisfaction indices were related to the respondent's income and occupation, but 5 were related to educational level. Satisfaction with health care services was generally higher in this rural population than among the people in four urban areas that were surveyed using the same satisfaction indices.The question raised by the findings in this survey-are rural areas in general as deprived and unsatisfied with health care as the literature suggests-remains unsettled. Changes over time in use and patient satisfaction are being assessed in the resurvey to seek possible explanations of the low utilization and high degree of patient satisfaction in this area.

Adolescent↗