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Journal of Applied Gerontology
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Geographic Access and Service Use in a Community-Based Sample of Cognitively Impaired Elders

John Fortney

Central Arkansas Veterans Healthcare System, and University of Arkansas for Medical Sciences

Neale Chumbler

North Florida/South Georgia Veterans, Health Care System and the University of Florida

Marisue Cody

Central Arkansas Veterans Healthcare System, and University of Arkansas for Medical Sciences

Cornelia Beck

University of Arkansas for Medical Sciences

Objective: The purpose of this research was to determine whether geographic access influences service utilization in a community-based sample of older adults with cognitive impairment. Methods: A telephone screener for cognitive impairment was administered to 9,100 elderly Arkansans with caregivers, resulting in a sample with 317 elder/caregiver dyads. Self-reported service utilization was collected for three sectors: home health, physical health, and mental health. Geographic access was measured from (a) self-reported awareness of services in each sector and (b) the travel time to the closest provider in each sector calculated using a Geographic Information System. Results: Travel time significantly predicted home health service utilization while perceived awareness significantly predicted mental health service utilization. Neither measure of geographic access predicted use of physical health services. Discussion: Because rural elders with less geographic access receive fewer home/mental health services, they may be at greater risk for hospitalization or nursing home placement.

Journal of Applied Gerontology, Vol. 21, No. 3, 352-367 (2002)
DOI: 10.1177/073346480202100305
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