In the past two years, rural patients in British Columbia have paid more than $1,500 out of pocket, on average, on travel and accommodations needed to access health care, a new study has found.
Nearly 80 per cent of respondents to the Centre for Rural Health Research survey reported difficulty paying for their care, and 60 per cent said travelling to access care had negatively impacted their health.
“There’s incurring lost wages from missing work or child care, and unsupported travel becomes exponentially more difficult when there’s a need for continued, episodic care,” Dr. Jude Kornelsen, report co-author and co-director of the Centre for Rural Health Research, told Global News.
“Not just for specialist care, but now people are travelling to access some primary care services as we are challenged with keeping our primary care services afloat.”
Between November 2019 and March 2020, the Centre for Rural Health Research surveyed 381 adult, rural British Columbians who had travelled to access health care in the past two years. They answered 71 questions about their expenses, patient experience, distance travelled, stress level, and more.
The 316 whose complete responses were analyzed spent an average of $856 on transport and $674 on accommodations. The costs have resulted in some vulnerable, low-income patients choosing not to seek care, said Paul Adams, executive director of the BC Rural Health Network.
“Obviously there’s a cost associated with that downstream as an acute problem becomes a chronic condition if untreated,” he said in an interview. “We see a lot of inefficiencies in current systems and we see the ability to streamline processes to ensure people do seek the appropriate care.”
Across the country, provincial governments have struggled to provide specialist services, and in some cases, primary care services in rural communities. The level of demand may not justify the infrastructure expense and employers often have difficulty recruiting and retaining the right medical professionals.
Health Minister Adrian Dix said both the demand for quality of care and expertise in care have increased in B.C., while the system has become increasingly centralized. That has saved the system itself from travel costs, he added, and despite the expansion of patient link bus and air ambulance services, more investment is needed.
“There’s some things people are going to have to travel to,” Dix said at the legislature. “The other thing we’re going to have to look at are our travel assistance programs.
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“We have expanded them somewhat, but it is a continuing challenge in the health care, and to use virtual care more effectively, which I think is really valuable in specialist care.”
The province’s population over 75 is set to double, meaning a roughly equivalent doubling in many of the ailments that come with old age, Dix added. It’s something the government is planning for in its 10-year cancer plan, he explained, noting that some care will need to return to rural communities.
It’s a change Clearwater Mayor Merlin Blackwell would like to see. Blackwell said he spent seven or eight weeks living in his mom’s Vancouver laundry room in his twenties because he couldn’t afford a motel stay for the length of his cancer treatment.
“I was living below the poverty line working in radio back then,” he told Global News. “Yes, there’s other ways to do it — things like a hospice and that sort of the thing — but it’s not easy and it needs to be easy and it really needs to be easy.
“We need to take the doubt out of whether you should go for treatment or not. For rural patients, it should be automatic … the cost will be covered.”
– With files from Richard Zussman
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