Frontier residents' perception of health care access
Smith, Raymond Joshua
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It can be difficult to access health care due to cost, lack of insurance, and lack of available resources for Americans today. Frontier persons have even more obstacles in accessing health care due to geography, time and distance to facilities, lack of medical personal, and culture. This study's purpose was to better understand frontier residents' perceptions of access to health care. Specific aims were to (a) explore frontier residents' health care access resources, (b) investigate frontier residents' utilization of health care services, (c) search for reasons frontier residents seek health care (d) and explore the residents' overall satisfaction regarding their health care access options. A qualitative approach that included open-ended questions was used to interview a convenience sample of 11 frontier residents in a Southwestern Montana town. Participants were recruited using a snowball approach. Common themes were extracted using a "low inference" analysis style. Aday and Andersen's framework and their study of access to medical care (1975) guided the study. Results revealed most residents felt they had access to health care and all had seen a provider in the last 2 years. Residents used "local" services, the closest being 70 miles away, for minor ailments and injuries or when home remedies failed. A "by-pass" mentality of "local" services was seen for more serious events. Children were treated differently and health care was sought sooner if they became ill. Reasons for seeking care included preventative services, acute injuries, and infectious processes. Cost, weather, road conditions, gas prices, travel time, and taking time off work were mentioned as barriers in health care utilization. Insurance deductibles and costs of health services limited the type of health care residents sought. Satisfactions with health care providers were high as well as sliding scale fees of the local health centers. Cost and distance were unsatisfactory. Implications for practice include educating residents about benefits and abilities of their local resources, the need to seek care for preventative services, health promotion topics, and disease prevention. In addition, health care authorities should focus on alternative ways to bring health care to the frontier residents including telemedicine and lowering costs.