Perceived barriers to health care access among rural older adults: a qualitative study.
BACKGROUND
Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access.


OBJECTIVE
To examine what barriers rural elders report when accessing needed health care, including how they cope with the high cost of prescription medication.


METHODS
During Spring 2001, thirteen 90-minute focus groups were conducted in 6 rural West Virginia communities. A total of 101 participants, aged 60 years and older, were asked several culminating questions about their perceptions of health care access.


RESULTS
Five categories of barriers to health care emerged from the discussions: transportation difficulties, limited health care supply, lack of quality health care, social isolation, and financial constraints. In addition, 6 diverse coping strategies for dealing with the cost of prescription medication were discussed. They included: reducing dosage or doing without, limiting other expenses, relying on family assistance, supplementing with alternative medicine, shopping around for cheapest prices, and using the Veteran's Administration.


CONCLUSIONS
Overall, rural older adults encounter various barriers to accessing needed health care. Qualitative methodology allows rural elders to have a voice to expound on their experiences. Research can contribute valuable information to shape policy by providing a forum where older adults can express their concerns about the current health care delivery system.
Goins
R Turner
RT
Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV, USA. rgoins@hsc.wvu.edu
Williams
Kimberly A
KA
Carter
Mary W
MW
Spencer
Melinda
M
Solovieva
Tatiana
T
D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions / Q000191:economics; D005260:Female; D005382:Financing, Personal; D017144:Focus Groups; D006297:Health Services Accessibility; D006299:Health Services for the Aged / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D019035:Rural Health Services / Q000592:standards / Q000706:statistics & numerical data*; D012923:Social Class; D012934:Social Isolation; D014186:Transportation; D014903:West Virginia