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.