Growth in Physicians and Advanced-Practice Nurses in Counties Targeted by the Robert Wood Johnson Foundation's Southern Rural Access Program: 2002 and 2003

Publication Date: October 2005

Publisher: Robert Wood Johnson Foundation; Cecil G. Sheps Center for Health Services Research, University of Carolina at Chapel Hill

Author(s): T.R. Konrad; J. Groves; D.E. Pathman; S. Thaker; T.C. Ricketts

Research Area: Health

Type: Report

Abstract:

In 1997 the Robert Wood Johnson Foundation (RWJF) solicited proposals from health care leaders in southeast states for a new initiative, the Southern Rural Access Program (SRAP). The program's goal was to support programs to increase the supply of primary care providers in underserved areas and strengthen the health care infrastructure of states and communities and their capacity to address their health needs. Through initial funding and subsequent renewal grants, the program has provided over $30 million for four types of initiatives intended to:

* recruit and retain primary health care practitioners
* develop a cadre of health professions students committed to careers as leaders in primary care in underserved areas (“pipeline” initiatives)
* develop collaborative networks of rural health providers to foster joint planning and programs
* create revolving loan programs to give rural providers access to affordable capital needed to expand facilities and services.

In early 1999 RWJF hired rural health researchers at the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill to conduct a four-year evaluation of SRAP. The three principal activities of the funded evaluation were to:

* assess whether the SRAP grantees' initiatives were measurably improving the availability of primary health care professionals in the program's targeted counties and parishes
* assess whether population survey indicators of access to health care showed access was improving in SRAP-targeted communities
* document grantees' success in implementing their planned initiatives through analyses of their progress report data.

The findings of this report suggest that SRAP enhanced the growth of primary care physicians but not of specialist physicians or nurse practitioners in target counties. The increase in primary care physicians was most marked in the poorest regions. Evaluation data from subsequent years will allow the evaluators to determine if this growth pattern continues into the future.