Roger A. Rosenblatt, MD, MPH Laura-Mae Baldwin, MD, MPH Leighton Chan, MD, MPH Meredith A. Fordyce, PhC Irl B. Hirsch, MD Jerry P. Palmer, MD George E. Wright, PhD Gary L. Hart, PhD Seattle, Washington Submitted, revised, March 26, 2001. From the University of Washington departments of Family Medicine (R.A.R., L.M.B., M.A.F., G.E.W., L.G.H.), Rehabilitation Medicine (L.C.), and Medicine (I.B.H., J.P.P.). Reprint requests should be addressed to Roger Rosenblatt, MD, MPH, University of Washington, Department of Family Medicine, Box 354696, Seattle, WA 98195-4696. E-mail: rosenb@u.washington.edu.
References
The fact that the highest-quality care occurs in large remote rural communities may contain some lessons for the optimal organization of health services. These are communities that have moderate-sized hospitals, a balanced mix of generalists and specialists, and population sizes between 10,000 and 50,000 people. There may be advantages to living in areas such as these where patients are not exposed to the potentially deleterious effect of too few physicians or fragmentation of services amidst a surplus of specialists. Future studies are needed to determine if these findings can be generalized to the care of other patients and other conditions.
Acknowledgments
Our work was funded by a grant from the Federal Office of Rural Health Policy, the Robert Wood Johnson Foundation, and the Agency for Health Care Policy and Research.
Related Resources
American Diabetes Association www.diabetes.org Definitive source of patient-centered information about diabetes and its treatment.
Canadian Diabetes Association http://www.diabetes.ca/ Information on insulin, nutrition, research, complications of diabetes, juvenile diabetes and other disease-related issues. Resources for patients and physicians.
National Institute of Diabetes and Digestive Diseases and Kidney Diseases http://www.niddk.nih.gov/ Health education programs and publications on diabetes for patients, Information on clinical trials and research funding opportunities for physicians, faculty and researchers.
