key: cord-1018553-4ab7ycwp
authors: Lakhani, Ali
title: Introducing the Percent, Number, Availability, and Capacity [PNAC] Spatial Approach to Identify Priority Rural Areas Requiring Targeted Health Support in Light of COVID‐19: A Commentary and Application
date: 2020-04-11
journal: J Rural Health
DOI: 10.1111/jrh.12436
sha: 3cf284a47a5e197c51506d37049526a912a40fb7
doc_id: 1018553
cord_uid: 4ab7ycwp

nan

During December 2019, a new coronavirus (COVID-19) was identified in Wuhan, China. 1 The spread of COVID-19 since identification has quickly emerged as a global issue with the World Health Organization declaring a pandemic on March 11. 2 To date (March 29, 2020) there have been over 716,000 reported cases across 177 countries/regions, with deaths approaching 34,000. 1 Those who are older than 65 years of age generally face the most extreme consequences of contracting COVID-19.

Data from the United States of America (USA) have confirmed that up to 30% of people 65 or older contracting COVID require hospitalization, while up to 10% will die. 3 Aging populations in rural and remote communities may be especially vulnerable to the COVID-19 pandemic, and in part, this is due to the availability and capacity of rural health services.

Edwards et al. 4 investigated the perspectives that rural hospital decision-makers had in relation to service delivery during a pandemic avian influenza scenario. Findings from 17 hospitals concluded that key issues surround (i) a lack of staff, (ii) the need for coordinated health services, and (iii) 

People aged 65 and older were considered the population of interest for this COVID-19 case study, as those 65 and older who contract COVID-19 generally experience the most severe consequences necessitating hospital admission. Data for this case study were identified from a set of public and nonpublic data being collated for use within the Epidoros-V2 spatial platform. 13 This article is protected by copyright. All rights reserved. 4

Data. 16 As a bed range is provided (for example, 0-50 beds, 50-100 beds), the upper bound of each range was used, except for hospitals with greater than 500 beds, where the number 500 was used. [Insert Figure 1 Here] [Insert Figure 2 Here]

The PNAC approach can be applied to support rural health service planners' identification of priority This article is protected by copyright. All rights reserved. 5

Availability, the number of services available within a specified radius (as done in my earlier work 17 ), or the geographic location where services are clustered (as done by Chandak et al. 6 ) may be best.

Rural locations have distinct demographic and health service capacity issues requiring tailored approaches to service delivery. It is expected that future applications of the PNAC method could be of particular benefit to rural service planning in light of COVID-19, as the approach considers both the demographic distribution (for example age) and service capacity issues unique to rural areas. However, it is important that COVID-19 service planning decisions within regions identified via the PNAC method are culturally and contextually appropriate, and they are informed by stakeholders with lived-experience working within identified rural areas.

CSSE Coronavirus COVID-19 Global Cases (dashboard)

COVID-19): Older Adults

Promoting Regional Disaster Preparedness Among Rural Hospitals

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