Nearly 20% of people on Medicare have to travel 50 or more miles to see their neurologists — and that’s just one way. This means that people who receive care for neurological issues have to make quite an effort to do so. And many of them who make the trip don’t follow up compared to those who have doctors closer to home.
The statistic comes from a report published Wednesday in Neurology. People with brain cancer, amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS) travel the long distances most often.
The study was conducted in 2018, so telemedicine wasn’t much of a factor.
“Our study found a substantial travel burden exists for some people with neurologic conditions, including people living in areas with fewer neurologists and rural areas,” Brian C. Callaghan, MD, study author and neurology professor at University of Michigan Health in Ann Arbor, said.
Not only are travel times a hassle for many people, but they may hamper care.
“We also found that people who traveled long distances were less likely to return for a follow‐up visit with a neurologist,” Callaghan added.
Researchers combed data on more than 563,000 people using Medicare who saw a neurologist at least once during a one-year span. The average age was 70. During the study 14,439 neurologists provided care to people across more than 1.2 million office visits.
Over 96,000 people, or 17%, had to travel more than 50 miles to their neurologists. The average one-way trip was 81 miles, and the average travel time for that trip was 90 minutes.
Those not traveling 50 miles or more went, on average, 13 miles to see their neurologists. One-way travel took 22 minutes.
People with brain and spinal cord cancers tended to travel more. IN fact, 40% of them traveled 50 miles or longer, while 30% of people with ALS traveled over 50 miles and 23% of people with MS had the same long haul.
Where people lived affected their travel times. People who lived in areas with fewer neurologists had a three times greater chance of going over 50 miles compared to people who lived with more neurologists nearby. People living in rural areas had a five times greater chance of having to travel more than 50 miles one way compared to people living in urban areas. People who traveled over 50 miles for a primary care doctor visit were three times more likely to travel at least 50 miles to see their neurologists.
“It is possible some people bypass the nearest neurologist as a matter of preference for a particular physician or they may need to travel farther to reach neurologists with shorter wait times,” Callaghan said.
During the first three months of the study, more than 165,000 people saw neurologists for the first time and 62,000 had at least one follow-up visit with the same neurologist. People who had to haul over 50 miles one way were 26% less likely to follow up compared to those who could get to their neurologists without going over 50 miles one way.