title: Middle-Aged and Older Adult Health Care Selection.
abstract: This study assesses the prevalence of primary-care physician (PCP) bypass among rural middle-aged and older adults. Bypass is a behavior where people travel beyond local providers to obtain health care. This article applies a precise Geographic Information System (GIS)-based measure of bypass and examines the role of community and non-health-care-related characteristics on bypass. Our results indicate that bypass behavior among rural middle-aged and older adults is multifaceted. In addition to the perceived quality of local primary care, dissatisfaction with local services, such as shopping, creates an effect that increases the likelihood of bypass, whereas strong community ties decrease the likelihood of bypass. The results suggest that the "outshopping theory," where respondents select services in larger regional economic centers rather than local "mom and pop" providers, now extends to older adult health care selection.
authors: 1 Brigham Young University, Provo, UT, USA.
authors: Scott R
authors: SR
authors: Sanders
authors: 1 Brigham Young University, Provo, UT, USA.
authors: Lance D
authors: LD
authors: Erickson
authors: 1 Brigham Young University, Provo, UT, USA.
authors: Vaughn R A
authors: VR
authors: Call
authors: 1 Brigham Young University, Provo, UT, USA.
authors: Matthew L
authors: ML
authors: McKnight
mesh_terms: D000368:Aged; D005260:Female; D040362:Geographic Information Systems; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009009:Montana; D015999:Multivariate Analysis; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012424:Rural Population; D012959:Socioeconomic Factors; D013997:Time Factors; D014186:Transportation
keywords: health care bypass; health care selection; rural older adult health care