Health services access and use among older adults in North Carolina: urban vs rural residents.

Abstract

OBJECTIVES. This study compared health service use and satisfaction with health care among older adults living in urban vs rural counties in North Carolina. METHODS. A stratified random sample of 4162 residents of one urban and four rural counties of North Carolina was surveyed to determine urban/rural variation in inpatient and outpatient health service use, continuity of care and satisfaction with care, and barriers (transportation, cost) to care. RESULTS. Inpatient and outpatient service use did not vary by residence in controlled analyses. Continuity of care was more frequent in rural counties. Transportation was not perceived as a barrier to health care more frequently in rural than in urban counties, but cost was a greater barrier to care among rural elderly people. CONCLUSIONS. In this sample, older persons living in rural counties within reasonable driving distance of urban counties with major medical centers used health services as frequently and were as satisfied with their health care as persons in urban counties. Cost of care, however, was a significant and persistent barrier among rural elderly people, despite Medicare coverage.

Transportation to Clinic: Findings from a Pilot Clinic-Based Survey of Low-Income Suburbanites

“…While we would not suggest that the statistics reported here are readily generalizable, the magnitude of transportation difficulty reported by our suburban sample meets (and in many cases exceeds) that found in several national population-based studies [7,8], and is comparable to that found in several samples of patients in rural settings. [9][10][11]. Our findings are consistent with the perceptions of suburban health care leaders interviewed reported by Felland [1].…”

Physical Therapy Use by Community-Based Older People

“…These findings are similar to those reported by other researchers who have examined the effect of metropolitan status on health care use among older people. 17,20,41,42,48 There was some geographic variation in physical therapy use and amount of physical therapy received (as measured by cost and number of visits). Relative to the South Atlantic census division, physical therapy use was less in the East South Central census division and greater in the Pacific census division, and amount of physical therapy received was less in the West North Central and West South Central census divisions.…”

Park Sağlık Ocağı Bölgesinde Kayıtlı Olan 15 Yaş Üstü Kişilerin Son Bir Ayda Sağlık Sorunu İle Karşılaşma ve Sağlık Kurumuna Başvurma Durumları

“…Yurt dışında yapılmış çalışmalarda da sağlık hizmetlerinin kullanımında benzer güçlükler yaşandığı gö-rülmektedir. Estrada ve arkadaşları, düşük gelir sahibi olanların, gençlerin, sağlık güvencesi olmayanların, fiziksel kısıtlılığı olanların, sağlık düzeyi kötü olanların diğer gruplara göre daha çok engelle karşılaştıklarını, Andersen ve arkadaşları, Amerika'da yaşayan azınlık grupların sağlık hizmetlerini kullanmada çeşitli sorunlar yaşadıklarını, Blazer ve arkadaşları kentsel ve kırsal alanda yaşayan yaşlılar arasında sağlık hizmeti sunan birimlerin kullanımı açısından farklılık olmadığını ancak maliyetin kırsal alanda yaşayan grup için önemli bir güçlük olduğunu belirtmiştir (4,5,19). DSÖ' nün 2000 yılında herkes için sağlık hedefleri doğrultu-sunda sağlık hizmetlerinden yararlanmada karşıla-şılan güçlük ve engellerin tespit edilmesi, bu engellerin ortadan kaldırılması tüm dünyada ve ülke-mizde ulaşılabilir bir hedef olarak öngörülmekte-dir (20).…”