Document Type

Capstone Experience

Graduation Date

5-2025

Degree Name

Master of Public Health

Department

Health Services Research & Administration

First Committee Member

Steven Peters, MA

Second Committee Member

David Palm, PhD

Third Committee Member

Hongmei Wang, PhD

Fourth Committee Member

Vietta Swalley

Abstract

Challenges with obtaining access to healthcare in rural communities continue to be a clear issue. There are both structural and economic issues that limit patient access to care. With geographic issues also affecting access, many patients in Nebraska must travel further and wait longer throughout most rural communities to receive needed care. Care services seem to be retracting vs expanding, and patients continue to seek options that are closer to home and more comprehensive in scope. It is vital for communities and health services organizations to assess all care options and services they can expand or currently have to attract more rural patients. This study provides a comprehensive evaluation of the community care needs along with a feasibility analysis to determine the actions needed to expand access to care at the Santee Health and Wellness Center (Health Center) in Niobrara, Nebraska. The Santee Health and Wellness Center is a tribally managed, outpatient, ambulatory health center in Northeast Nebraska on the Santee Sioux Reservation. This study examines the potential impacts to the Health Center if non-American Indian clientele were allowed to utilize Health Center services. A market analysis, and a review of the potential structural and policy steps needed for expanding services to non- Indian populations is provided in addition to a final recommendation report.

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