Rural community-dwelling elders' reports of access to care: Are there Hispanic versus non-Hispanic white disparities?

Context: Consumer reports can provide useful information about the dimensions of access in need of improvement for particular population subgroups. Purpose: To determine if there are Hispanic versus non-Hispanic white disparities in rural elders' reports of their health care access. Methods: A telephone survey was conducted among 2,097 rural community-dwelling elders in West Texas. Dependent variables included reports of the ability to obtain care (see personal doctor/nurse, see specialist, obtain help over phone, and obtain transportation to the clinic) and reports of the ability to obtain care without a long wait (get help over the phone without a long wait, see provider for illness/injury when wanted, see provider for routine care when wanted, and have short office waiting times). Independent variables included predisposing, enabling, and need factors. Univariate and multivariate logistic regression analyses were conducted. Findings: In univariate logistic analyses, Hispanics had worse reports of their ability to always/usually see their personal doctor, see a specialist, obtain transportation to the clinic, see a doctor for illness/injury when wanted, and see a doctor for routine care when wanted. When adding enabling factors to the models, only reports of the ability to see a doctor for illness or injury and for routine care when wanted remained significant. Conclusions: Though the rural medical care system may need to target directly Hispanics to improve their timely access to acute and routine care, the enhancement of health insurance coverage may lead to improved access to personal doctors and specialists among all rural elders.