Are There Diagnostic Testing Inequities in Rural Areas?

 

More Programs and Publications Featuring Dr. Brandy Gunsolus

In this program:

Do patients in rural areas experience diagnostic testing inequities? Medical laboratory scientist Dr. Brandy Gunsolus discusses common equity gaps that occur for those who live in rural communities.

Transcript

Interviewer:

So how does rural medicine present its own diagnostic testing issues or its own set of inequities? Do individuals in rural or remote areas come at a disadvantage when accessing these necessary diagnostic tests? Is there a way for providers to reduce this?

Dr. Brandy Gunsolus:

So, rural medicine is it's even has, its own area in medicine. [chuckle] Unfortunately, most rural medicine providers have very limited access to diagnostic testing and even healthcare in general, they may be able to diagnose a heart attack, but they may not be able to have all of the treatment that that patient needs. They may not be able to get...they may not have a cath lab, a heart cath lab to get that patient to as quickly as possible. In fact, they're more than likely not going to have that available. Rural medicine providers may not have access to rapid molecular testing in order to detect infectious diseases such as gonorrhea and chlamydia. They may have to ship those specimens off. And I will say that even though it's much cheaper to ship specimens off, I could tell you that there's been lots of times where specimens are lost. That's just one of the things that once it leaves your site, a specimen will get lost in transit and it happens.

It's unfortunate, but it does, this happens more than often with rural medicine providers than it does with providers that are located in an urban area. You also have more issues in rural medicine with specimens that you have more issues in rural medicine with specimens that actually they disintegrate before they can be tested. There are certain tests that have a very limited stability, so they're only good for a few hours. And when you're in rural medicine, you can't get that specimen to an appropriate testing laboratory before that specimen expires, and it's no longer any good for testing. So that does also provide challenges in for patients that are in rural areas, it's unfortunate that healthcare has really come to this point in rural areas for... There have been a big push to, for a number of years to put medicine out in rural areas. Unfortunately, many of those hospitals, whether they were acute care hospitals in rural areas or critical access hospitals in rural areas, have actually gone out of business in the last 15 to 20 years because our current system in healthcare is really unsustainable.

It costs more to provide the healthcare than what we get reimbursed from insurance companies. And rural medicine just does not have the tax basis or the support that it needs to stay in business. And so while these disparities have been there, they've... They're only getting worse as time goes on. And you can do a quick internet search on hospitals that have closed. And you'll see that the vast majority of hospitals that have closed have been in rural areas, just creating the disparities even more.

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