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      Exposing some important barriers to health care access in the rural USA

      Author(s): , , ,
      Publication date Created:
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      Journal: Public Health
      Publisher: Elsevier BV

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          Abstract

          To review research published before and after the passage of the Patient Protection and Affordable Care Act (2010) examining barriers in seeking or accessing health care in rural populations in the USA.

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          Health literacy and the digital divide among older Americans.

          Helen Levy, Alexander T Janke, Kenneth M Langa (2015)
          Among the requirements for meaningful use of electronic medical records (EMRs) is that patients must be able to interact online with information from their records. However, many older Americans may be unprepared to do this, particularly those with low levels of health literacy.
          Article 0 comments Cited 82 times – based on 0 reviews     Review now
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            Impact of patient distance to radiation therapy on mastectomy use in early-stage breast cancer patients.

            Anneke T Schroen, David R Brenin, John Kelly … (2005)
            Treatment access underlies quality cancer care. We hypothesize that mastectomy rates in a rural state are independently influenced by distance to radiation therapy (XRT) and by changing XRT access through opening new facilities. Early-stage breast cancer patients diagnosed from 1996 to 2000 were identified in the Virginia state registry. Distance from patient zip code to nearest XRT facility was calculated with geographical software. Distance to XRT facility ( 10 to 25, > 25 to 50, and > 50 miles), American Joint Committee on Cancer tumor stage, age, race, and diagnosis year were evaluated for influencing mastectomy rate. Mastectomy use within 15 miles of five new facilities was assessed before and after opening. Among 20,094 patients, 43% underwent mastectomy, 53% underwent lumpectomy, and therapy of 4% of patients is unknown. Twenty-nine percent of patients lived more than 10 miles from XRT facility. Mastectomy increased with distance to XRT facility (43% at 10 to 25 miles, 53% at > 25 to 50 miles, and 58% at > 50 miles; P 10 to 25 miles, 41% at > 25 to 50 miles, and 49% at > 50 miles; P < .001). In multivariate analysis, mastectomy use was independently influenced by XRT distance after adjusting for age, race, T stage, and diagnosis year. Over the study period, mastectomy rates declined from 48% to 43% across Virginia, and there were similar declines in a 15-mile area around four new radiation facilities in urban settings. However, mastectomies decreased from 61% to 45% around a new XRT facility in a rural setting. Distance to XRT facility significantly impacts mastectomy use. Opportunities for increasing breast-conservation rates through improved XRT access exist.
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              ACOG Committee Opinion No. 586: Health disparities in rural women.

              (2014)
              Rural women experience poorer health outcomes and have less access to health care than urban women. Many rural areas have limited numbers of health care providers, especially women's health providers. Rural America is heterogeneous where problems vary depending on the region and state. Health care professionals should be aware of this issue and advocate for reducing health disparities in rural women.
              Article 0 comments Cited 47 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: Public Health
                Abbreviated Title: Public Health
                Publisher: Elsevier BV
                ISSN (Print): 00333506
                Publication date Created: June 2015
                Publication date (Print): June 2015
                Volume: 129
                Issue: 6
                Pages: 611-620
                Article
                DOI: 10.1016/j.puhe.2015.04.001
                PubMed ID: 26025176
                SO-VID: d988206b-80df-4743-ba71-c6b493653935
                Copyright © © 2015
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