Survey: Seniors willing to drive an hour for primary care access

Older adults are willing to drive up to an hour to get to a primary care appointment, according to a new JAMA Network Open study, indicating that seniors are willing to make tradeoffs to ensure they can get the care they need from the clinician they like.

These findings are key, as the United States faces dual challenges of a silver tsunami straining the healthcare system and a dwindling primary care provider workforce, the researchers said.

Right now, adults over age 65 are among the most likely to access primary care. According to the researchers, 91% have a usual source of care, compared to 86% of all adults.

This is good news, as seniors tend to have greater medical needs. Primary care providers are key to meeting those needs and quarterbacking chronic disease prevention and management.

But as the number of seniors seeking medical care continues to grow, the nation is predicted to have fewer primary care providers to meet demand.

March 2024 numbers from the AAMC showed that the U.S. will see a physician shortage of up to 86,000 physicians by 2036. According to the Bureau of Labor Statistics (BLS), the geographic distribution of primary care providers is also slated to change, as more providers choose to practice in urban and suburban areas as opposed to rural regions.

Increasing patient demand and decreasing provider workforce numbers will put a strain on the patient experience, particularly in terms of patient access to care.

In this latest study, the researchers specifically looked at travel time to care. Right now, three-quarters of adults over age 65 travel 30 minutes or less to see their primary care providers. With more patients trying to see fewer doctors, that number is likely to grow.

But how long is too long to be driving to the doctor? Using survey data from more than 4,500 adults age 65 or older, the researchers were able to determine that threshold.

Across all respondent demographics, the average acceptable travel time was 53 minutes, meaning senior adults were willing to drive just shy of an hour to see their primary care provider.

That number differed based on geography. For adults living in urban areas, the acceptable travel time was 48 minutes, compared to 53 minutes for suburban adults and 61 minutes for rural adults.

These findings are reflective of the provider demographic changes flagged by BLS. Acknowledging that there are simply fewer primary care providers in their area, adults living in rural regions are willing to travel a little further for care.

What's more, adults who were older, had higher incomes, were White, had higher educational attainment, lived in an urban or suburban area and had shorter current travel times were more likely to say they'd be willing to increase their travel time to the doctor.

Those trends could lead to some health disparities, the researchers noted.

If seniors will need to travel further to see the doctor in the future, and only White, high-income folks in urban and suburban areas are able to increase their travel times, it could mean that others are set up to go without care.

"Our findings suggest that substantial increases in travel time could discourage primary care use among individuals with lower income and education, racial and ethnic minority individuals, urban residents and individuals with longer travel time," the researchers concluded. "Interventions aimed at alleviating transportation barriers to health care access should consider these populations."

Sara Heath has reported news related to patient engagement and health equity since 2015.