Transportation Considerations for Implementing COPD Programs
Transportation presents a critical challenge to COPD treatment in rural communities. Rural communities are often more geographically dispersed compared to urban areas, so there may be longer distances between an individual's home and healthcare settings. In addition, lower-resource rural communities often have fewer specialty respiratory care services, so rural residents may need to travel outside of their regions to urban or suburban communities to access care. The National Advisory Committee on Rural Health and Human Services policy brief, Addressing the Burden of Chronic Obstructive Pulmonary Disease (COPD) in Rural America, highlighted distance and transportation as particular burdens in the management of rural COPD, citing findings that in 2013 only 34.5% of rural residents had access to a pulmonologist within 10 miles, compared to 97.5% of urban residents. Longer distances create additional time and resource burdens for patients traveling to primary care or pulmonary rehabilitation appointments for COPD.
In addition, not all COPD patients are able to drive. Some may depend on caregivers for transportation. Others may rely on public transportation between appointments; however, there is limited public transportation infrastructure within and across rural areas, in addition to limited service during severe weather. Also, patients with more severe COPD may struggle to access bus stops or train stations due to decreased physical mobility and difficulty breathing. Primary care and specialty respiratory providers can help increase patient access to COPD services by providing transportation services.
For more information, please see RHIhub's Rural Transportation Toolkit.