The use of community surveys for health planning: The experience of 56 Northwest rural communities

A rural health services development program of the University of Washington School of Medicine has worked for 15 years with communities throughout the five-state region of Alaska, Idaho, Montana, Washington and Wyoming to str engthen their health systems. Or the course of that work, 56 communities we re surveyed about their utilization and opinions of local health systems. T his database allows the following generalizations to be made about rural No rthwest communities: (1) People think highly of their local hospitals, phys icians and other key components of the acute medical care system and want t heir hospitals to remain open. Older respondents are more satisfied than yo unger respondents; (2) the typical hospital market share is 36 percent, the typical physician market share is 50 percent (3) satisfaction with discret e, well-funded services such as pharmacy ambulance and dentistry is quite h igh, whereas satisfaction with mental health and substance abuse treatment is significantly lower; (4) the most commonly cited serious problems in sur veyed communities were "too few physicians or-services" and "care is too ex pensive" and (5) there is great variation between communities in both satis faction and utilization.