Quality of care in the rural context: a proposed research agenda

The quality of health care provided in rural areas is critical to rural patients and providers and will shape the future evolution of the rural health care system. Past research has focused almost exclusively on disease-specific comparisons of the quality of care rendered in rural as compared with urban areas, which ignores the fact that it is the functioning of the entire system of care that determines whether or not rural residents receive high quality care. Future research should focus on the functioning of the entire rural system of care. To accomplish this objective, we suggest investments in the following areas: the creation of a national database that collects information on the process and outcome of care delivered to rural populations, the incorporation of human factors research into our research agenda, greater emphasis on the importance of sociodemographic and cultural issues to the quality of care, and a shift to a focus on populations as opposed to individuals.