Access to transportation and health care utilization in a rural region
Access to transportation and health care utilization in a rural region
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DOI：
10.1111/j.1748-0361.2005.tb00059.x
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发表时间：
2005-12-01
影响因子：
4.9
通讯作者：
Powers, JM
中科院分区：
文献类型：
--
作者：
Arcury, TA;Preisser, JS;Powers, JM
背景：在农村地区，必须有交通工具来跨越住宅和保健服务之间的遥远距离。然而，很少有研究直接访问交通在农村卫生保健利用的分析。目的：本分析涉及在农村地区的交通和卫生保健利用的关联。研究方法：本研究以北卡罗来纳州西部12个县的1,059户居民为样本，分析了不同交通方式对居民医疗服务利用率的影响，同时考虑了个人特征、健康特征和距离的影响。调查结果：那些有驾驶执照的人有2.29倍的医疗保健访问慢性护理和1.92倍的访问定期检查护理比那些没有。有家人或朋友可以提供交通工具的受访者的长期护理访问次数是没有的人的1.58倍。虽然在多变量分析中不显着，但使用公共交通的少数人每年比不使用公共交通的人多4次慢性病护理访问。年龄和较低的健康状况也与增加的医疗保健访问有关。与医疗保健访问显着相关的交通变量表明，基本的概念框架，健康行为模型和Hagerstrand的时间地理，是有用的理解交通行为。结论：进一步的研究必须解决与医疗保健相关的交通行为和影响这种行为的因素。这些信息将为解决农村社区医疗保健地理障碍的政策选择提供信息。
Context: Access to transportation to transverse the large distances between residences and health services in rural settings is a necessity. However, little research has examined directly access to transportation in analyses of rural health care utilization. Purpose: This analysis addresses the association of transportation and health care utilization in a rural region. Methods: Using survey data from a sample of 1,059 households located in 12 western North Carolina counties, this analysis tests the relationship of different transportation measures to health care utilization while and justing for the effects of personal characteristics, health characteristics, and distance. Findings: Those who had a driver's license had 2.29 times more health care visits for chronic care and 1.92 times more visits for regular checkup care than those who did not. Respondents who had family or friends who could provide transportation had 1.58 times more visits for chronic care than those who did not. While not significant in the multivariate analysis, the small number who used public transportation had 4 more chronic care visits per year than those who did not. Age and lower health status were also associated with increased health care visits. The transportation variables that were significantly associated with health care visits suggest that the underlying conceptual frameworks, the Health Behavior Model and Hagerstrand's time geography, are useful for understanding transportation behavior. Conclusions: Further research must address the transportation behavior related to health care and the factors that influence this behavior. This information will inform policy alternatives to address geographic barriers to health care in rural communities.