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Abstract
Rural Americans face several health care access barriers, including limited providers, driving further to receive care, and higher rates of uninsured residents. Health care access in Georgia is especially problematic given the state’s high rurality, hospital closure rate, number of Health Professional Shortage Areas, and older adult population. The U.S. government has attempted to improve health care access by promoting the Patient-Centered Medical Home (PCMH) model. This dissertation promotes a better understanding of older Georgian’s access to care by exploring PCMH’s ability to improve health care access.
Older adults were surveyed using a modified version of the Healthcare Quality Survey to examine health care access in rural Georgia. Several analyses were employed, including univariate, bivariate (t-test, ANOVA, chi-square, and crosstabulations), and multivariate (multiple linear regression). Health care access was statistically significantly different depending on care source type, with significant associations between PCMH users and income, age, locale type, and health status. Access was also statistically significantly different based on annual household income, educational attainment, age, and health status. Further, a significant relationship was found between access and age, income, and health status. Significance was also determined between local health care quality satisfaction and locale type and health status. PCMH users were primarily Caucasian and most often had an advanced degree and income of $60,000 or more.
Residents of the top regions reporting always having access to health care were Heart of Georgia, Three Rivers, Northeast Georgia, and the Atlanta Region. Additionally, PCMH users most often reported living in Three Rivers, Atlanta Region, Northeast Georgia, and the Georgia Mountains. Finally, urban and rural residents with a regular care source reported always receiving needed care more often than PCMH users and those with no care source. The National Committee for Quality Assurance and other accreditation agencies might benefit from targeting rural areas that are low-income and with high older adult populations to implement the PCMH model to increase older Georgians’ access to health care.
Older adults were surveyed using a modified version of the Healthcare Quality Survey to examine health care access in rural Georgia. Several analyses were employed, including univariate, bivariate (t-test, ANOVA, chi-square, and crosstabulations), and multivariate (multiple linear regression). Health care access was statistically significantly different depending on care source type, with significant associations between PCMH users and income, age, locale type, and health status. Access was also statistically significantly different based on annual household income, educational attainment, age, and health status. Further, a significant relationship was found between access and age, income, and health status. Significance was also determined between local health care quality satisfaction and locale type and health status. PCMH users were primarily Caucasian and most often had an advanced degree and income of $60,000 or more.
Residents of the top regions reporting always having access to health care were Heart of Georgia, Three Rivers, Northeast Georgia, and the Atlanta Region. Additionally, PCMH users most often reported living in Three Rivers, Atlanta Region, Northeast Georgia, and the Georgia Mountains. Finally, urban and rural residents with a regular care source reported always receiving needed care more often than PCMH users and those with no care source. The National Committee for Quality Assurance and other accreditation agencies might benefit from targeting rural areas that are low-income and with high older adult populations to implement the PCMH model to increase older Georgians’ access to health care.