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Access to transportation substantially influences rural residents' use of health care services

A recent study supported by the Agency for Healthcare Research and Quality (HS09624) underscores the critical importance of transportation to care access for rural residents. The researchers found, for example, that people living in rural areas who had a driver's license had double the number of chronic care and regular care visits in a year than other rural residents who were unlicensed. Having family or friends provide regular transportation and use of public transportation also increased health care use.

In this study, the median distance to care was only about 6.5 miles. Yet the findings indicate that without transportation, even short distances can be an insurmountable problem, explains Thomas A. Arcury, Ph.D., of Wake Forest University School of Medicine.

Dr. Arcury and his colleagues used survey data from a sample of 1,059 households in 12 western North Carolina counties to examine the relationship between direct access to transportation and health care use. Individuals who had a driver's license had 2.29 times as many health care visits for chronic care and 1.92 times as many visits for regular checkups as those who did not have a license.

People whose family or friends could provide transportation had 1.58 times as many visits for chronic care as those who did not have such help. The small number (48 individuals) who used public transportation had four more chronic care visits per year as those who did not. Older age and poorer health were also associated with more health care visits. The researchers conclude that greater emphasis needs to be placed on ensuring that transportation resources are available to rural residents.

See "Access to transportation and health care utilization in a rural region," by Dr. Arcury, John S. Preisser, Ph.D., William M. Gesler, Ph.D., and James M. Powers, M.Sc., in the Winter 2005 Journal of Rural Health 21(1), p. 31-38.

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