Dr. Luisa Franzini, chair of the Health Services Administration department at the University of Maryland School of Public Health, is leading a Maryland Health Care Commission-funded study ($450,000), in partnership with the Walsh Center for Rural Health Analysis at the National Opinion Research Center (NORC) Bethesda, to help lawmakers decide on the best ways to deliver healthcare to five counties on Maryland’s eastern shore. It is hoped that this study will be used as a model for delivering care in rural areas of the state.
[Photo: Dr. Luisa Franzini]
The study was launched in response to a strong community reaction when a proposal was made to change rural Kent County Hospital from an acute care hospital to a different kind of medical facility. The news triggered strong local reaction, including the formation of a citizens’ “Save Our Hospital” group. As a result, the Maryland state legislature passed a bill that froze any changes to the hospital for now, and called for a study on how best to deliver health care, not just in the area served by this hospital, but also in the five rural shore counties of Maryland.
Maryland is one of the few states that compiles comprehensive information in one database detailing all insurance claims filed. Thanks to an agreement with the state of Maryland, the University of Maryland School of Public Health has access to this database in order to carry out research projects, like this one, that guide policymakers in their decisions on healthcare issues.
Hand-in-hand with the data analysis will be five focus groups, public hearings, and interviews to hear directly from people in the communities about their healthcare practices and their needs.
“We are expected to deliver some option models for how to deliver care” using all of this input, Dr. Franzini said, noting that NORC has expertise in models of rural healthcare. Based on both the data and the interview processes, they will evaluate the different available methods and perhaps develop new models of care.
When the Maryland state legislature funded this project, Dr. Franzini said, they also created a Rural Health Workgroup of about 35 lawmakers, hospital CEOs, county school officials, and healthcare business people. This group will consider the research findings of Dr. Franzini’s team and the Walsh Center, and come up with the recommendations that will be considered by the legislature.
Among the issues Dr. Franzini said they would be considering are vulnerable populations, mental health, telehealth options, and transportation issues. “The point was made repeatedly that the area differs by season because of tourism,” Dr. Franzini said, referring to the heavy flow of summer beach traffic up and down Route 50—the region’s major north-south artery. Even though much of the eastern shore is rural farmland, the heavy traffic on any given beach weekend may be a literal roadblock to someone trying to access care.