USING QUALITATIVE METHODS TO EVALUATE HEALTH-SERVICE DELIVERY IN 3 RURAL COLORADO COMMUNITIES

Qualitative and quantitative methods can be used simultaneously for hy pothesis generation and testing. A pilot study was conducted in 1991 i n three rural Colorado communities to clarify health service delivery problems related to cancer. The analysis focused on the perceptions of three types of respondents in each community related to whether cance r was a major problem, whether health services were adequate in their community, and what perceived solutions could be implemented. Responde nts included community influentials, health care providers, and cancer patients or family members. Semistructured phone interviews were used to collect perceptions of these community members. Transcripts from t he three communities were combined, coded, and tallied. Several distin ct themes emerged from the analysis. These included: cancer was a majo r problem; public and provider education was needed; community systems and support to identify and solve health problems are lacking; medica l networking needed to be expanded; transportation was a problem for r emote communities; inability to pay for services was a problem for rur al communities. Most respondents identified the problems as relevant t o other chronic and acute diseases as well as cancer This method ident ified the critical problems for the majority of the people without lov ing sight of the outlier responses.