Access to Specialty Care for COPD

While primary care providers are a critical component of COPD care coordination, specialty pulmonary services are necessary for comprehensive treatment. The most common specialty service is pulmonary rehabilitation, which includes exercise interventions and consultations with respiratory therapists or dietitians. In more extreme cases, COPD patients may require lung surgery if medications or pulmonary rehabilitation are not effective. In addition, COPD patients may require specialty care services for other commonly comorbid conditions, such as cardiovascular services for heart disease or dialysis services for diabetes.

However, there is often a lack of specialty pulmonary services for COPD in rural communities. As such, rural patients may need to travel substantially farther than their urban counterparts to receive care. Limited access to specialty care can negatively impact COPD treatment adherence and disease management. Programs that operate remotely to engage with patients in hard-to-reach areas could help increase access to care within resource-constrained settings. For example, the Bay Rivers Telehealth Alliance's Bridges to Care Transitions program supports the implementation of remote patient monitoring devices in conjunction with coaching for patients with COPD. Programs that incentivize specialty providers to practice in rural communities could increase access to specialty care services for COPD among rural patients. The Rural Healthcare Workforce and Recruitment and Retention for Rural Health Facilities topic guides have additional information on recruitment and workforce initiatives.

Resources to Learn More

Availability of Respiratory Care Services in Critical Access and Rural Hospitals
Document
A policy brief discussing the availability and importance of respiratory care services and respiratory therapists in rural settings.
Author(s): Casey, M., Evenson, A., Moscovice, I., & Zhengtian, W.
Organization(s): University of Minnesota Rural Health Research Center
Date: 6/2018