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Access to Physician Care for the Rural Medicare Elderly
There is some concern that the care provided to elderly Medicare beneficiaries living in small and isolated rural towns is less, more distant, and reflects a different mix of specialist care than their urban and large rural city counterparts. This study described where Medicare beneficiaries in five states obtain their health care, how far they travel for that care, and the mix of physician specialties from which they obtain ambulatory care. Special attention was paid to beneficiaries who have dual Medicare-Medicaid status, who reside in poorer income areas, and who live in designated Health Professional Shortage Areas. Analyses examined the care obtained by beneficiaries with selected chronic conditions. The data upon which the analyses were based consisted of the 1998 Medicare Part B data for South Carolina, North Carolina, Idaho, Alaska, and Washington. These data contain information on physician visits, specialty type, patient home and encounter locations, diagnoses and procedures, and patient demographics. Demographic and Rural-Urban Commuting Area (RUCA) codes were linked to the encounter data, and road travel distances and times involved in obtaining care were determined.
Publications
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Geographic Access to Health Care for Rural Medicare Beneficiaries
Author(s): Leighton Chan, L. Gary Hart, David C. Goodman
Report Number: Working Paper No. 97
Date: 04 / 2005
This study looked at where Medicare beneficiaries of five states obtain their care, how far they travel for that care, and the mix of physician specialties from whom they obtain their ambulatory care. Findings from this study suggest that rural residents do not rely on urban areas for the majority of their care. Those living in small and isolated rural areas have decreased geographic access to health care providers, particularly specialists, and rely heavily on generalists for the majority of their care. Additionally, results of the study suggest that these individuals have few visits overall and must travel longer distances to access certain types of care. These findings have policy implications for geographic reimbursement differentials, telehealth networks, and graduate medical education. Report available upon request by contacting rhrc@fammed.washington.edu.
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Geographic Access to Health Care for Rural Medicare Beneficiaries
Author(s): Leighton Chan, L. Gary Hart, David C. Goodman
Citation: Journal of Rural Health 22(2),140-146
Date: 2006
Describes the results of a study comparing the travel times, distances, and physician specialty mix of all Medicare patients living in Alaska, Idaho, North Carolina, South Carolina, and Washington.
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