北卡罗来纳州老年人的医疗服务可及性与使用情况：城市居民与农村居民对比
Health services access and use among older adults in North Carolina: urban vs rural residents.
作者信息
Blazer D G, Landerman L R, Fillenbaum G, Horner R
机构信息
Department of Psychiatry, Duke University Medical Center, Durham, NC, USA.
出版信息
Am J Public Health. 1995 Oct;85(10):1384-90. doi: 10.2105/ajph.85.10.1384.
OBJECTIVES
This study compared health service use and satisfaction with health care among older adults living in urban vs rural counties in North Carolina.
METHODS
A stratified random sample of 4162 residents of one urban and four rural counties of North Carolina was surveyed to determine urban/rural variation in inpatient and outpatient health service use, continuity of care and satisfaction with care, and barriers (transportation, cost) to care.
RESULTS
Inpatient and outpatient service use did not vary by residence in controlled analyses. Continuity of care was more frequent in rural counties. Transportation was not perceived as a barrier to health care more frequently in rural than in urban counties, but cost was a greater barrier to care among rural elderly people.
CONCLUSIONS
In this sample, older persons living in rural counties within reasonable driving distance of urban counties with major medical centers used health services as frequently and were as satisfied with their health care as persons in urban counties. Cost of care, however, was a significant and persistent barrier among rural elderly people, despite Medicare coverage.
目的
本研究比较了居住在北卡罗来纳州城市和农村县的老年人对医疗服务的使用情况以及对医疗保健的满意度。
方法
对北卡罗来纳州一个城市县和四个农村县的4162名居民进行分层随机抽样调查，以确定住院和门诊医疗服务使用情况的城乡差异、医疗连续性以及对医疗的满意度，还有就医障碍（交通、费用）。
结果
在控制分析中，住院和门诊服务的使用情况不因居住地区而异。农村县的医疗连续性更为频繁。农村地区并不比城市地区更常将交通视为医疗保健的障碍，但费用对农村老年人来说是更大的就医障碍。
结论
在这个样本中，居住在距离设有主要医疗中心的城市县合理驾车距离内的农村县的老年人使用医疗服务的频率与城市县的老年人相同，并且对医疗保健的满意度也相同。然而，尽管有医疗保险覆盖，医疗费用对农村老年人来说仍是一个重大且持续存在的障碍。
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