Mary K. Wolfe and Noreen C. McDonald are with the Department of City and Regional Planning, University of North Carolina at Chapel Hill. G. Mark Holmes is with the Department of Health Policy and Management and North Carolina Rural Health Research and Policy Analysis Center at the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
Am J Public Health. 2020 Jun;110(6):815-822. doi: 10.2105/AJPH.2020.305579. Epub 2020 Apr 16.
To quantify the number of people in the US who delay medical care annually because of lack of available transportation and to examine the differential prevalence of this barrier for adults across sociodemographic characteristics and patient populations. We used data from the National Health Interview Survey (1997-2017) to examine this barrier over time and across groups. We used joinpoint regression analysis to identify significant changes in trends and multivariate analysis to examine correlates of this barrier for the year 2017. In 2017, 5.8 million persons in the United States (1.8%) delayed medical care because they did not have transportation. The proportion reporting transportation barriers increased between 2003 and 2009 with no significant trends before or after this window within our study period. We found that Hispanic people, those living below the poverty threshold, Medicaid recipients, and people with a functional limitation had greater odds of reporting a transportation barrier after we controlled for other sociodemographic and health characteristics. Transportation barriers to health care have a disproportionate impact on individuals who are poor and who have chronic conditions. Our study documents a significant problem in access to health care during a time of rapidly changing transportation technology.
为了量化美国每年因缺乏可用交通工具而延迟医疗护理的人数，并研究这种障碍在成年人中的不同流行程度与社会人口特征和患者群体之间的关系。我们使用了国家健康访谈调查（1997-2017 年）的数据，以研究这一障碍在不同时期和不同群体中的表现。我们使用联合点回归分析来确定趋势的显著变化，并使用多元分析来研究 2017 年这一障碍的相关因素。2017 年，美国有 580 万人（1.8%）因缺乏交通工具而延迟了医疗护理。自研究期间之前或之后的这一窗口以来，2003 年至 2009 年期间，报告交通障碍的比例有所增加，但没有明显的趋势。我们发现，西班牙裔人、生活在贫困线以下的人、医疗补助计划的接受者以及有功能障碍的人在控制了其他社会人口和健康特征后，更有可能报告交通障碍。交通障碍对贫困和患有慢性病的人获得医疗服务的影响不成比例。我们的研究记录了在交通技术迅速变化的时期，医疗保健获取方面存在一个重大问题。
