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Patient Travel Distance to Neurologist Visits
Chun Chieh Lin1, Chloe E Hill2, Kevin A Kerber2
1From the Department of Neurology (C.C.L., C.E.H., L.B.D.L., B.C.C.), University of Michigan, Ann Arbor; Department of Neurology (C.C.L., K.A.K., J.F.B.), the Ohio State University, Columbus; Department of Neurology (L.E.S.), Northwestern University, Chicago, IL; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; and Department of Neurology (A.H.), Yale University, New Haven, CT. Anna.Lin@osumc.edu.
Nearly 1 in 5 Medicare patients traveled over 50 miles for neurologist care, especially for rare conditions. Low neurologist density and rural areas significantly increase this long-distance travel for neurological conditions.
Area of Science:
- Neurology
- Healthcare Access
- Geographic Health Disparities
Background:
- Neurologist density varies significantly across the US.
- Patient travel distance and time to neurologist visits are not well-characterized.
- Understanding factors influencing travel for neurological care is crucial for improving access.
Purpose of the Study:
- To measure patient travel distance and time to neurologist visits across different neurologic conditions and subspecialties.
- To identify factors associated with long-distance travel for neurological care.
Main Methods:
- Cross-sectional analysis of a 2018 Medicare sample.
- Defined long-distance travel as ≥50 miles one-way.
- Used multilevel generalized linear mixed models to analyze patient and regional characteristics associated with long-distance travel.
Main Results:
- 17% of 563,216 Medicare beneficiaries traveled long-distance (≥50 miles) for neurologist visits.
- Long-distance travel was most common for nervous system cancer (39.6%), ALS (32.1%), and MS (22.8%).
- Low neurologist density, rural location, and prior long-distance travel for primary care were associated with increased travel.
Conclusions:
- Nearly 1 in 5 Medicare beneficiaries experience significant travel burdens for neurologist care.
- Low neurologist density and rural settings are key predictors of long-distance travel.
- Interventions like telemedicine and supporting local neurologists may improve access to care.
