
Access to medical care is a recurring issue across the health care industry. A study from researchers at Yale University has found that millions of Americans are geographically isolated from pulmonary rehabilitation for conditions such as COPD.
For the study, which was published in JAMA Network Open, researchers used massive geographic data sets and computational infrastructure to compute hundreds of millions of travel times. What they found was that — while around 80% of Americans live within a 30-minute drive of a pulmonary rehabilitation program — more than 14 million people (mostly in the western and midwestern regions) must travel more than an hour for access to their nearest rehabilitation facility.
The study also uncovered racial disparities, including the fact that nearly 30% of the American Indian and Alaska Native populations live more than an hour away from the closest rehab program.
Peter Kahn, MD, a pulmonary and critical care fellow at Yale School of Medicine and lead author of the study, said telemedicine and virtual rehabilitation can help bridge the gap in the short term, but the long-term effectiveness of these approaches still needs additional evaluation.
Helping patients in the long term will require more accessible in-person rehabilitation options, which will require collaboration between policy makers and health care providers along with different approaches to insurance reimbursement.
“Insurance payers, both government and private, do not sufficiently reimburse pulmonary rehabilitation programs for the people, equipment and supplies needed to effectively run them,” Dr. Kahn said. “That represents a barrier to offering these programs. Of equal importance, insurance limits how many rehabilitation sessions a patient can attend.”