Utilization of Health Care Resources by the Amish of a Rural County in Nebraska.

ABSTRACT

The medical needs of the New Order Amish (NOA) remain poorly understood. The NOA community in Pawnee County, Nebraska was founded in 2011 by members from across the Midwest. Understanding what this community wants from their medical providers informs how rural hospitals may best serve the needs of growing NOA populations. To address this, the current utilization of the closest healthcare resource to community were assessed. Medical records data for Amish patients were obtained at Pawnee County Memorial Hospital and Rural Health Clinic from 2011 to 2016. Subjective data were obtained by surveys and interviews administered to Amish in Pawnee County. The 422 complete interactions in the medical record covered most primary care complaints. The fifteen survey respondents valued direct interaction with providers and expressed concerns about cost, emergencies, and access to obstetric practice. Surprisingly, though surveys indicated minimal use of health establishments for many common health complaints, medical records indicated frequent doctor visits for myriad reasons. Naturalistic books were the most utilized source of health information. The NOA utilize formal medicine, but may feel excluded in medical decision-making. They desire better access to obstetric care and culturally sensitive medical practice. Providers should ensure appropriate communication to increase healthcare-related comfort of this underserved population.