title: Self-Reported Barriers to Healthcare Access for Rheumatoid Arthritis Patients in Rural and Northern Saskatchewan: A Mixed Methods Study.
abstract: The aim of the present study was to identify potential barriers for access to medical and allied health services from the perspective of rural and Northern Saskatchewan rheumatoid arthritis (RA) patients.
  
  
  
  A total of 100 adults with established RA, residing in rural and Northern Saskatchewan, were recruited from two rheumatology practices. Structured interviews with standardized scripts solicited patient perspectives on appointment waiting times, travel required to access medical services and satisfaction with healthcare provision. Thematic analysis was employed for qualitative data.
  
  
  
  Patients-reported concerns regarding waiting time for their first rheumatology appointment. There was reduced access to allied health professionals, with only 53% of the participants having seen a physiotherapist (PT), and only 26% an occupational therapist (OT). Patients had similar driving distances to their family physician, PT, pharmacy and laboratory services but commuted significantly further for rheumatologist and OT services. There were high levels of satisfaction with their rheumatologist and family physician appointments (8.96 and 8.04 on a ten-point scale). Patients with longer travel times had higher satisfaction with their health care appointments: Patients who travelled one, two and more than two hours had satisfaction scores of 0.93, 0.88 and 1.32 points higher on a ten-point scale (p < 0.03).
  
  
  
  Access to medical services is a concern for this population. Patients were dissatisfied with the waiting time for their first specialist appointment and with decreased access to allied health professionals. Patients travelling longer distances were more satisfied with their health care provider's care, suggesting that good patient-care giver relationships helped to ameliorate the difficulties of travelling to their appointments. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: B V
authors.initials: BV
authors.lastname: Nair
authors.affiliation: College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Schuler
authors.affiliation: Clinical Research Centre, Dalhousie University, Halifax, NS, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Stewart
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: R M
authors.initials: RM
authors.lastname: Taylor-Gjevre
mesh_terms: D001172:Arthritis, Rheumatoid / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012525:Saskatchewan
keywords: Healthcare access; rheumatoid arthritis; rheumatology; rural and remote