title: Barriers to accessing specialist care for older people with chronic obstructive pulmonary disease in rural New Zealand.
abstract: BACKGROUND
  Access to health care for people living in rural areas presents many challenges. For people who live with chronic obstructive pulmonary disease (COPD), the ability to access specialist health services facilitates improved health outcomes, however many barriers to accessing specialist health care have been identified. This paper reports on the challenges people living with COPD in rural New Zealand (NZ) face in accessing specialist health care services.
  
  
  METHODS
  Nine people living with COPD in a small NZ rural town were interviewed in 2007.
  
  
  RESULTS
  Data analysis, using a general inductive approach found that difficulties with transportation, physical access, communication and finances collectively added up to significant barriers to accessing specialist care for this group of people.
  
  
  CONCLUSIONS
  The findings raise questions about the model of care needed to improve health care for rural people with COPD. Collaborative multidisciplinary teams with specialist respiratory nurses working in the community are proposed to improve care coordination and improve communication for this group of people.
authors.affiliation: Community Services for Older Adults and Home Health, Waitemata District Health Board, Auckland, New Zealand.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hopley
authors.forename: Margaret
authors.initials: M
authors.lastname: Horsburgh
authors.forename: Kathy
authors.initials: K
authors.lastname: Peri
mesh_terms: D000368:Aged; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D051346:Mobility Limitation; D009520:New Zealand; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D036301:Qualitative Research; D019035:Rural Health Services / Q000592:standards / Q000600:supply & distribution*; D013038:Specialization; D014186:Transportation