Penn State College of Medicine, Hershey, PA, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241266114. doi: 10.1177/21501319241266114.
To characterize the impact of rural patients' travel time to obtain healthcare on their reported utilization of preventive healthcare services and personal health outcomes.
Online survey data from rural adults ages 50+ years living in the Northeastern United States were collected from February to August 2021. Study measures included self-reported travel time to obtain healthcare, use of preventive healthcare, and health outcomes. The associations between travel time with use of preventive care and health outcomes were assessed using linear, Poisson, and logistic regression analyses controlling for demographic variables.
Our study population included 1052 rural adults, with a mean travel time of 18.5 min (range: 0-60). Travel time was greater for racial/ethnic minority participants and for higher-income participants (both < .05), but it was not associated with use of preventive healthcare. Greater travel time was associated with poorer mental health and more comorbidities, including cancer and diabetes (all < .05).
Travel time varied by patient demographic factors, and it was associated with mental health and comorbidities. There was no association between travel time and preventive care use, suggesting that other barriers likely contribute to suboptimal use of these services within rural communities. Further research is needed to elucidate the causal pathways linking travel time to mental health and comorbidities within rural communities, as increased travel may exacerbate intrarural health disparities.
本研究旨在描述农村患者就医交通时间对其预防保健服务利用和个人健康结果的影响。
本研究于 2021 年 2 月至 8 月期间,通过在线调查收集了美国东北部农村地区 50 岁以上成年人的数据。研究指标包括患者报告的就医交通时间、预防保健服务的使用情况和健康结果。采用线性、泊松和逻辑回归分析方法,控制人口统计学变量,评估交通时间与预防保健服务使用和健康结果之间的关联。
本研究共纳入 1052 名农村成年人,平均就医交通时间为 18.5 分钟(范围:0-60 分钟)。少数民族和高收入患者的交通时间更长(均 < .05),但与预防保健服务的使用无关。较长的交通时间与较差的心理健康状况和更多的合并症(包括癌症和糖尿病)相关(均 < .05)。
患者的人口统计学因素会影响就医交通时间,且其与心理健康和合并症相关。交通时间与预防保健服务的使用之间无关联,这表明在农村社区中,其他障碍可能会导致这些服务的利用不足。需要进一步研究来阐明交通时间与农村社区内心理健康和合并症之间的因果关系,因为增加交通可能会加剧农村内部的健康差异。