Study Finds 1 in 5 People on Medicare Travel 50 or More Miles to See a Neurologist

In a groundbreaking study published in the September 13, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology (AAN), it has been revealed that a significant portion of Medicare beneficiaries face substantial travel burdens to access neurologic care. This research sheds light on the challenges faced by individuals dealing with neurologic conditions, such as brain cancer, amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS), as they often travel long distances to see a neurologist. Let’s delve into the details of this eye-opening study that underscores the importance of improving access to specialized care.

Understanding the Travel Burden

The study, supported by the American Academy of Neurology, analyzed data from over 563,000 Medicare beneficiaries who had at least one neurologist visit during a one-year period. What became evident was that nearly 17% of these individuals, totaling over 96,000 people, had to travel long distances to access neurologic care. Long distance, in this context, was defined as a one-way journey of 50 miles or more, with an average travel time of 90 minutes.

The study also uncovered that individuals with specific neurologic conditions faced the greatest challenges. Among them, 40% of those with brain and spinal cord cancers, 30% with ALS, and 23% with MS had to travel long distances to consult with a neurologist. This paints a clear picture of the unique hurdles faced by these patient populations.

Factors Influencing Long-Distance Travel

Several factors contributed to the prevalence of long-distance travel. Notably, regions with fewer neurologists, where only 10 neurologists served 100,000 Medicare beneficiaries, had a threefold higher likelihood of long-distance travel compared to areas with 50 neurologists per 100,000 beneficiaries. Rural areas also posed a significant challenge, with a fivefold higher chance of long-distance travel compared to urban counterparts.

Interestingly, the study found that individuals who had to travel long distances to see their primary care physician were three times more likely to undertake a similar journey to consult with a neurologist. This indicates that accessibility to primary care may play a pivotal role in determining the ease of accessing specialized neurologic care.

The Impact on Follow-Up Care

Another critical finding of the study was the impact of long-distance travel on follow-up care. Participants who had to travel long distances experienced a 26% reduced likelihood of scheduling a follow-up visit with the same neurologist compared to those who had more accessible care options. This raises concerns about continuity of care and the potential consequences of interrupted treatment.

Addressing the Issue

The study’s lead author, Chun Chieh Lin, PhD, MBA, emphasized the need for policymakers to explore feasible and affordable solutions to improve access to neurologic care, particularly in underserved areas and rural communities. Telemedicine emerged as a promising intervention to bridge the geographical gap, offering remote consultations that can mitigate the challenges of long-distance travel.

It’s important to note that this study was conducted in 2018, prior to the COVID-19 pandemic. Future research should examine how the widespread adoption of telemedicine during the pandemic may have affected travel times and access to neurologic care.

Conclusion

The study’s findings underscore the significant hurdles faced by Medicare beneficiaries in accessing neurologic care, especially when dealing with conditions like brain cancer, ALS, and MS. Long-distance travel, often driven by the scarcity of neurologists in certain regions, can impact follow-up care and overall health outcomes. Policymakers and healthcare providers must work together to find innovative solutions, such as telemedicine, to ensure that all individuals have timely and equitable access to specialized neurologic care.

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FAQs

1. What is the main finding of the study on Medicare beneficiaries and neurologic care?

• The study revealed that a substantial number of Medicare beneficiaries, especially those with conditions like brain cancer, ALS, and MS, must travel long distances to see a neurologist.

2. What factors contribute to long-distance travel for neurologic care?

• Several factors influence long-distance travel, including a shortage of neurologists in certain regions, rural locations, and the need to travel long distances for primary care.

3. How does long-distance travel affect follow-up care with neurologists?

• Participants who had to travel long distances for neurologic care were 26% less likely to schedule follow-up visits with the same neurologist, highlighting the potential impact on continuity of care.

4. What solutions were suggested to address this issue?

• Policymakers are encouraged to explore options like telemedicine to improve access to neurologic care, especially in underserved areas and rural communities.

5. How has the COVID-19 pandemic influenced access to neurologic care?

• This study was conducted before the pandemic, and future research should investigate the impact of telemedicine during COVID-19 on travel times and access to neurologic care.