Lack of access to medical specialists puts small town residents at risk of dying sooner

ST. LOUIS — Living in a small town is quite different from life in a big city, but at the end of the day it’s all about personal preference and what works for each individual. However, just because someone doesn’t live in Manhattan or Chicago, that doesn’t mean they shouldn’t have access to adequate medical care and facilities. Unfortunately, a new study finds just that: residents of rural areas lack access to medical specialists, and are at a higher risk of being unnecessarily hospitalized and ultimately dying in comparison to city dwellers.

Researchers from Saint Louis University came to their conclusions after examining data collected between 2006-2013 on Medicare patients, from both rural and urban areas, suffering from chronic conditions. They then linked those patients’ Medicare claims to health care supply data from hospitals. The research team considered a “rural area” to be any town with less than 10,000 residents. They noted that 10% of studied Medicare beneficiaries lived in rural areas.

“People on Medicare with chronic conditions such as heart failure or diabetes who live in rural areas have higher death and hospitalization rates than their urban peers,” comments study leader Kenton Johnston, Ph.D., assistant professor of health management and policy at Saint Louis University College for Public Health and Social Justice, in a release. “The biggest reason for this appears to be that people in rural areas have less access to specialist physicians like cardiologists and endocrinologists.”

In light of these findings, Johnston and his fellow researchers are urging policymakers to work towards bringing more specialized care to small towns all over the United States.

A few of the study’s authors suggestions to fix this problem include utilizing technology, such as video conferencing, to ensure rural residents are able to speak with the specialists they need, even if said doctor may be hundreds of miles away.

Other ideas are to add financial incentives like loan forgiveness for doctors to work in rural areas, and different insurance payouts that offer doctors practicing in rural areas more money. Partnerships between rural and urban hospitals is another possibility, as well as contracting urban specialists to travel around rural towns on certain days each week.

According to the study’s results, patients who were able to see a specialist at least once, in addition to visiting a primary care physician, were 15.9% less likely to be hospitalized due to a preventable ailment. Perhaps more importantly, they were 16.6% less likely to die, in comparison to patients who were only able to visit a primary care doctor.

Furthermore, preventable hospital visits are most common in rural areas, and very infrequent in urban regions. All in all, small town residents had a 40% higher rate of preventable hospital visits and 23% higher mortality rates than city dwellers.

Johnston stresses that all Medicare patients with a chronic condition, such as heart disease or diabetes, should be aware of these findings.

“Our research shows that all Medicare beneficiaries with chronic conditions—urban and rural—have lower death and hospitalization rates when they visit a specialist at least once annually,” he concludes. “Primary care is important, but it is not enough by itself; specialist care is needed as well.”

The study is published in the scientific journal Health Affairs.

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