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Barriers to Accessing Care for Rural People with Disabilities

There are many barriers that people with disabilities face when accessing healthcare. People living with disabilities in rural and urban locations face many similar barriers when trying to access care, but rural residents typically have a significant disadvantage to receiving proper healthcare services.

Some of the barriers that are specific to rural communities include geographic isolation, qualified provider shortages, and the built environment characteristics of the local health clinic.

Geographic barriers: The geographic isolation of rural communities means that there are a limited number of clinic and hospital choices within an accessible radius as well as secondary and tertiary facilities with more sophisticated treatment capabilities. This can make care coordination even more difficult, especially for younger individuals with disabilities who are dually-eligible for Medicaid and Medicare.

Transportation barriers: Geographic isolation limits the transportation options available, according to focus groups conducted by Iezzoni and colleagues, many para-transport and public transportation systems will not travel to larger cities for medical appointments.

Physical and built environment barriers:

  • Inaccessible parking
  • Inaccessible sidewalks or no sidewalks
  • Poorly designed front desk that limits patient check-in
  • Inability to maneuver through clinic effectively
  • Poor exam room design and lack of appropriate equipment
  • Lack of handicap accessible restrooms
  • Limited resources to update clinics and fulfill other structural requirements for disabilities

Service barriers and provider shortages: In a 1996 Journal of Rural Health article, a shortage of trained medical staff, primary care physicians, and specialty care physicians, as well as poor retention of already employed physicians and little training available for medical staff, are identified as barriers to accessing primary and specialty care services. Other service barriers include a lack of TTY or hearing accessible phone services and readily available telehealth technology. There is little access to outreach and care teams or community health workers as well.

Cost barriers: Cost is a limiting factor in accessing care. Travel may be costly and many transportation options are not reimbursed by insurance. There are costs associated with obtaining regular medical care, even with health insurance. Cost is especially limiting if an individual is un- or under-employed.

Resources to Learn More

Rural Guide to Federal Health Professions Funding
Document
Addresses health provider shortages by identifying funding opportunities to encourage health professionals to work in rural communities.
Organization(s): U.S. Department of Health and Human Services Health Resources and Services Administration
Date: 5/2012