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Geographic access and service use in a community-based sample of cognitively impaired elders

Fortney JC, Chumbler NR, Cody M, Beck CK. Geographic access and service use in a community-based sample of cognitively impaired elders. Journal of applied gerontology : the official journal of the Southern Gerontological Society. 2002 Sep 1; 21(3):352-367.

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Abstract:

Objective: The purpose of this research was to determine whether geographic access influences service utilization in a community-based sample of older adults with cognitive impairment. Methods: A telephone screener for cognitive impairment was administered to 9,100 elderly Arkansans with caregivers, resulting in a sample with 317 elder/caregiver dyads. Self-reported service utilization was collected for three sectors: home health, physical health, and mental health. Geographic access was measured from (a) self-reported awareness of services in each sector and (b) the travel time to the closest provider in each sector calculated using a Geographic Information System. Results: Travel time significantly predicted home health service utilization while perceived awareness significantly predicted mental health service utilization. Neither measure of geographic access predicted use of physical health services. Discussion: Because rural elders with less geographic access receive fewer home/mental health services they may be at greater risk for hospitalization or nursing home placement.




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