Distance is Relative: Unpacking a Principal Barrier in Rural Healthcare

Colin Buzza; Sarah S Ono; Carolyn Turvey; Stacy Wittrock; Matt Noble; Gautam Reddy; Peter J Kaboli; Heather Schacht Reisinger

doi:10.1007/s11606-011-1762-1

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Distance is Relative: Unpacking a Principal Barrier in Rural Healthcare

Journal article

Open access

Peer reviewed

Distance is Relative: Unpacking a Principal Barrier in Rural Healthcare

Colin Buzza, Sarah S Ono, Carolyn Turvey, Stacy Wittrock, Matt Noble, Gautam Reddy, Peter J Kaboli and Heather Schacht Reisinger

Journal of general internal medicine : JGIM, Vol.26(Suppl 2), pp.648-654

11/2011

DOI: 10.1007/s11606-011-1762-1

PMCID: PMC3191222

PMID: 21989617

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Abstract

Background Distance to healthcare services is a known barrier to access. However, the degree to which distance is a barrier is not well described. Distance may impact different patients in different ways and be mediated by the context of medical need. Objective Identify factors related to distance that impede access to care for rural veterans. Approach Mixed-methods approach including surveys, in-depth interviews, and focus groups at 15 Veterans Health Administration (VHA) primary care clinics in 8 Midwestern states. Survey data were compiled and interviews transcribed and coded for thematic content. Participants Surveys were completed by 96 patients and 88 providers/staff. In-depth interviews were completed by 42 patients and 64 providers/staff. A total of 7 focus groups were convened consisting of providers and staff. Key results Distance was identified by patients, providers, and staff as the most important barrier for rural veterans seeking healthcare. In-depth interviews revealed specific examples of barriers to care such as long travel for common diagnostic services, routine specialty care, and emergency services. Patient factors compounding the impact of these barriers were health status, functional impairment, travel cost, and work or family obligations. Providers and staff reported challenges to healthcare delivery due to distance. Conclusions Distance as a barrier to healthcare was not uniformly defined. Rather, its importance was relative to the health status and resources of patients, complexity of service provided, and urgency of service needed. Improved transportation, flexible fee-based services, more structured communication mechanisms, and integration with community resources will improve access to care and overall health status for rural veterans.

Veterans

Rural Health

access to care

qualitative research

Original Research

Details

Title: Subtitle: Distance is Relative: Unpacking a Principal Barrier in Rural Healthcare
Creators: Colin Buzza - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region (VRHRC-CR), Iowa City VA Medical Center, 601 Highway 6 West, Mailstop 152, Iowa City, IA 52246–2208 USA
Sarah S Ono - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region (VRHRC-CR), Iowa City VA Medical Center, 601 Highway 6 West, Mailstop 152, Iowa City, IA 52246–2208 USA
Carolyn Turvey - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region (VRHRC-CR), Iowa City VA Medical Center, 601 Highway 6 West, Mailstop 152, Iowa City, IA 52246–2208 USA
Stacy Wittrock - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region (VRHRC-CR), Iowa City VA Medical Center, 601 Highway 6 West, Mailstop 152, Iowa City, IA 52246–2208 USA
Matt Noble - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region (VRHRC-CR), Iowa City VA Medical Center, 601 Highway 6 West, Mailstop 152, Iowa City, IA 52246–2208 USA
Gautam Reddy - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region (VRHRC-CR), Iowa City VA Medical Center, 601 Highway 6 West, Mailstop 152, Iowa City, IA 52246–2208 USA
Peter J Kaboli - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region (VRHRC-CR), Iowa City VA Medical Center, 601 Highway 6 West, Mailstop 152, Iowa City, IA 52246–2208 USA
Heather Schacht Reisinger - VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region (VRHRC-CR), Iowa City VA Medical Center, 601 Highway 6 West, Mailstop 152, Iowa City, IA 52246–2208 USA
Resource Type: Journal article
Publication Details: Journal of general internal medicine : JGIM, Vol.26(Suppl 2), pp.648-654
DOI: 10.1007/s11606-011-1762-1
PMID: 21989617
PMCID: PMC3191222
NLM abbreviation: J Gen Intern Med
ISSN: 0884-8734
eISSN: 1525-1497
Publisher: Springer-Verlag
Language: English
Date published: 11/2011
Academic Unit: Psychiatry; Epidemiology; Center for Social Science Innovation; Internal Medicine
Record Identifier: 9984094562002771

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