HEALTH-SERVICES ACCESS AND USE AMONG OLDER ADULTS IN NORTH-CAROLINA -URBAN VS RURAL RESIDENTS

Objectives. This study compared health service use and satisfaction wi th health care among older adults living in urban vs rural counties in North Carolina.Methods. A stratified random sample of 4162 residents of one urban and four rural counties of North Carolina was surveyed to determine urban/rural variation in inpatient and outpatient health se rvice use, continuity of care and satisfaction With care, and barriers (transportation, cost) to care. Results. Inpatient and outpatient ser vice use did not vary by residence in controlled analyses. Continuity of care was more frequent in rural counties. Transportation was not pe rceived as a barrier to health care more frequently in rural than in u rban counties, but cost was a greater barrier to care among rural elde rly people. Conclusions. In this sample, older persons living, in rura l counties within reasonable driving distance of urban counties with m ajor medical centers used health services as frequently and were as sa tisfied with their health cares persons in urban counties. Cost of car e, however, was a significant and persistent barrier among rural elder ly people, despite Medicare coverage.