Which of the following best describes why there are more ...

[tatyanajohnson]

Which of the following best describes why there are more long-term consequences (such as death) to a driver injured in a truck accident in a rural area than a driver injured in a truck accident in an urban area? (Select all that apply.)
 
  a. Rural drivers are more likely to speed over long distances than urban drivers.
  b. Rural drivers are not as skilled with vehicles as urban drivers, so they are more severely injured in a crash.
  c. The urban driver is taken immediately for care, whereas the rural driver might be injured on an isolated field and not found by anyone for hours.
  d. Urban drivers are more likely to use their seat belts than rural drivers.
  e. Urban drivers are probably rushed to an emergency department, whereas the rural driver lives far away from emergency services, often over bad roads and possibly through severe weather.
  f.
  Urban drivers trade their vehicles in rather frequently, whereas rural drivers keep their vehicles for as long as they can make them run, so the vehicles are much less roadworthy.

Question 2

Which of the following best describes why for-profit managed care organizations (MCOs) have not begun to move into rural areas to increase the number of persons served? (Select all that apply.)
 
  a. High startup and administrative costs are needed.
  b. A large number of elderly are on Medicare or Medicaid, which results in low reimbursement.
  c. Managed care has not yet had time to go beyond major population centers.
  d. MCOs are waiting until federal reimbursements for underserved rural health areas become higher.
  e. The population is too small and too spread out.
  f.
  Rural health areas are too geographically unattractive and lack any recreational possibilities for managers to want to work there.

[zhanghao]

Answer to Question 1

ANS: A, C, D, E
Getting patients from the place of injury to the trauma center within the golden hour is frequently not possible in rural areas because distance, terrain, climatic conditions, and communication methods produce barriers. Some rural facilities are more than 1 hour away by air from the nearest trauma center or tertiary care hospital. Driving at high speeds, driving long distances, driving in winter conditions, not using seat belts, and consuming alcohol have been cited as contributing to greater levels of injury deaths and disability by rural residents in the West. There is no evidence to suggest that rural drivers are not as skilled as urban drivers or that their vehicles are less roadworthy.

Answer to Question 2

ANS: A, B, C, E
MCOs recognize the risks to expanding into rural areas. Risks are probable high startup and administrative costs. Managed care has yet to move into much of rural America because of small dispersed populations, few visits per individual, and large numbers of elderly on Medicare with low-level reimbursements that do not make the aggregate financially attractive to MCOs. It is not likely that federal reimbursements for underserved rural health areas will become higher. The lack of attractive living for managers has not been a reason why MCOs have not moved into rural areas.

[tatyanajohnson]

Excellent

[alvinum]

TYSM