Socio-demographic differences in access to health care /
The research goal was to determine socio-demographic factors that discriminated access to chronic health services. The end-stage renal disease (ESRD) population presented a unique opportunity to study access for a chronically ill population while controlling for need, use, and financial barriers....
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| Format: | Thesis Book |
| Language: | English |
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[Place of publication not identified] :
[publisher not identified] ;
2000.
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| Subjects: | |
| Online Access: | http://proxy.library.tamu.edu/login?url=http://proquest.umi.com/pqdweb?did=731966281&sid=1&Fmt=2&clientId=2945&RQT=309&VName=PQD |
| Summary: | The research goal was to determine socio-demographic factors that discriminated access to chronic health services. The end-stage renal disease (ESRD) population presented a unique opportunity to study access for a chronically ill population while controlling for need, use, and financial barriers. These patients have an acute yet chronic need for medical care to remain alive and are eligible for federal and state funds for cost of this care. In 1997, an 18% random sample of chronic hemodialysis facilities in Texas was selected (N=40), stratified by urban/mid-sized/rural county population. A questionnaire was sent to all adult patients in the selected facilities (N=2108), with a response rate of 56% (N=1184). Hemodialysis patients in the study traveled a median of 15 miles (maximum 300 miles), and a median of 30 minutes (maximum 7 1/2 hours). In regression analysis of travel time to determine importance of need (chronicity); socio-demographics (age, race/ethnicity, gender, marital status, employment status); and availability (travel mode, rural/urban residence) - only rural residence accounted for greater travel time barriers (R²=.113; P<.001). Travel distance barriers were significantly greater for rural, younger, and Hispanic patients, with patients relying on others for transportation traveling significantly farther (R²=.157; P<.001). Fourteen percent of the study population relocated after ESRD onset, resulting in equivalent travel time and distance with those who did not relocate toward a closer source of care. Controlling for differences in travel time and distance, logistic analysis of the same predisposing factors in the model determined that minority patients, married patients, and patients with fewer years of treatment were significantly less likely to relocate in order to reduce access barriers in maintaining chronic treatment three times per week for the rest of their lives. Thus, socio-demographic factors continued to discriminate access to chronic care for hemodialysis patients in Texas, after controlling for financial, need and utilization factors. Travel and relocation support mechanisms may help reduce these barriers. Treatment facilities may focus on providing support mechanisms for these vulnerable patients who not only cope with chronic illness but also excessive barriers to obtain life-saving treatments. |
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| Item Description: | Vita. "Major Subject: Urban and Regional Science". |
| Physical Description: | ix, 135 leaves ; 28 cm. Issued also on microfiche from University Microfilm Inc. |
| Bibliography: | Includes bibliographical references (leaves 111-115). |