Goins R Turner, Williams Kimberly A, Carter Mary W, Spencer Melinda, Solovieva Tatiana
Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV, USA.
J Rural Health. 2005 Summer;21(3):206-13. doi: 10.1111/j.1748-0361.2005.tb00084.x.
Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access.
To examine what barriers rural elders report when accessing needed health care, including how they cope with the high cost of prescription medication.
During Spring 2001, thirteen 90-minute focus groups were conducted in 6 rural West Virginia communities. A total of 101 participants, aged 60 years and older, were asked several culminating questions about their perceptions of health care access.
Five categories of barriers to health care emerged from the discussions: transportation difficulties, limited health care supply, lack of quality health care, social isolation, and financial constraints. In addition, 6 diverse coping strategies for dealing with the cost of prescription medication were discussed. They included: reducing dosage or doing without, limiting other expenses, relying on family assistance, supplementing with alternative medicine, shopping around for cheapest prices, and using the Veteran's Administration.
Overall, rural older adults encounter various barriers to accessing needed health care. Qualitative methodology allows rural elders to have a voice to expound on their experiences. Research can contribute valuable information to shape policy by providing a forum where older adults can express their concerns about the current health care delivery system.
许多农村老年人获得医疗保健的机会有限。我们对这个问题的了解大多基于定量研究，然而定性研究可能会为个人对医疗保健可及性的看法提供更多见解。
研究农村老年人在获得所需医疗保健时报告的障碍，包括他们如何应对处方药的高昂费用。
2001年春季，在西弗吉尼亚州西部的6个农村社区进行了13次90分钟的焦点小组讨论。共有101名60岁及以上的参与者被问及几个关于他们对医疗保健可及性看法的最终问题。
讨论中出现了五类医疗保健障碍：交通困难、医疗保健供应有限、缺乏高质量医疗保健、社会孤立和经济限制。此外，还讨论了6种应对处方药费用的不同策略。它们包括：减少剂量或不用药、限制其他开支、依靠家庭援助、用替代药物补充、四处寻找最便宜的价格以及使用退伍军人管理局。
总体而言，农村老年人在获得所需医疗保健方面遇到各种障碍。定性方法使农村老年人能够表达他们的经历。通过提供一个老年人可以表达对当前医疗保健提供系统担忧的论坛，研究可以为制定政策贡献有价值的信息。
