The rural hospital project: conceptual background and current status.

Rural hospitals are confronting continuing and increasing threats to their viability. A demonstration project for the Washington-Alaska-Montana-Idaho region to address the problems of the rural hospital and health system is described. The assumptions underlying the project are that the rural hospital represents the most important component of the rural health care system, and the role of the rural hospital must be defined in relation to the broad health care needs of the population it serves. However, since the elements of community health services are also interdependent, a comprehensive approach to addressing the broad array of problems which besiege rural health services has been developed. The phases of this comprehensive health services development model are described. This approach is having a substantial impact on the ability of community health care leaders to work together, identify important problems, and initiate a range of interventions, with results that are encouraging for the future of the rural hospital and health care system.