Researchers looking into health care in rural areas are hearing that barriers to transportation and travel are major concerns.
That’s one of the common themes found by the Rural Evidence Review, a study being conducted by the University of British Columbia’s Centre for Rural Health Research.
“Transport and travel, the dangers and issues faced when people have to travel,” summarizes Christine Carthew, one of the lead researchers. “That can include a lack of transportation options, but also the financial and social costs if you can’t travel with your family. We saw that concern across every care type.”
The centre has been soliciting responses from the public as part of a multi-year project into rural health care, gathering citizen opinion on that care, and researching those opinions.
So far, more than 1,600 people have responded from over 210 communities, says Carthew.
Researchers want to know the priorities rural citizens have for health care, and ideas on how those issues can be addressed.
“Emergency care, primary care, maternity care, elderly care, litearally every type of care under the sun came up as a priority,” says Carthew. “Underscoring each of those priorities were discussions of the challenges or barriers faced when you have to travel for care… financial, social, your physical safety. So that was interesting, the barriers to access really underpinned each of those care types.”
Carthew’s group will take the information and do literature reviews on selected topics to see how such issues have been addressed elsewhere.
Out of that evidence comes policy recommendations for government and health administrations.
Some clear messages came out of the answers — mostly having to do with the cost and availability of transportation for health care, and the cost of staying away from home to receive health care.
Not surprisingly, researchers were told that “mountainous terrain and dangerous weather make travelling to other communities for care very difficult.”
Rural citizens face physical and financial barriers when travelling for health care, researchers were told.
“Expectant mothers from some communities need to pay for lodging outside their community for up to four weeks prior to their delivery,” is one example given, “and have to travel for hours to a neighbouring commuinty with maternity services should they go into labour early.”
Lack of health care locally can mean seniors have to leave their communities, as do sick persons who could benefit from support from friends and family. People can experience long wait times for specialist or diagnostic services.
There’s also a shortage — and not enough recognition of — mental health and substance abuse issues in rural areas, respondents said.
Conversely, some larger communities feel services to their own citizens are strained trying to provide health care to people in the larger catchment area.
The lack of local access to care means missed or delayed services as a result of the difficulties and costs surrounding travel; a reduction in the integrity of communities; and people being treated without the benefit of their local community and family support networks.
Not surprisingly, the survey found a strong desire for better services in rural areas. Among the suggestions included expanding of the care types being offered in smaller locations, better and more equipment, expanded hours of operation for existing health care facilities, and more walk-in clinics or non-emergent care centres to reduce pressure on emergency wards.
More should also be done to expand the number of healthcare workers in rural communities by offering greater incentives for doctors and nurses to move there.
If those things can’t be done, then access should be improved to healthcare in the larger centres, respondents told researchers. Mobile health vans or visiting specialists could reduce the need for people to travel for their care; telehealth or remote-care could be enhanced; providing funding for patients and their family to travel for care; and even allow people who live near Alberta to cross the border for care.
The researchers will now take the responses, and research the major themes to see how such issues have been dealt with in other jurisdictions.
Further research into the costs associated with accessing healthcare for rural residents is already the focus of another study being done by a different branch of the Centre for Rural Health Research.
They’re looking to hear citizen’s experience with the cost of travel for receiving health care.
Meanwhile, the Rural Evidence Review is also continuing to solicit citizen comments on its main survey. The effort will continue until 2021, and rural residents are still welcome to provide feedback.
PARTICIPATE: Rural Evidence Review
“We’re so grateful so many people have participated,” says Carthew. “We didn’t anticipate the response we received.”
Carthew says they’ll continue to share their findings as they are collected and processed.