An exploration of rural-urban differences in healthcare-seeking trajectories: Implications for measures of accessibility

Comparing accessibility between urban and rural areas requires measurement instruments Lha L are equally discriminating in each context. Through focus groups we explored and compared care seeking trajectories W understand context-specific accessibility barriers and facilitators. Rural care -seekers rely more on telephone access and experience more organizational accommodation but have fevver care options. Urban care seekers invoke the barrier of distance more frequently. Four consequences of accessibility problems emerged across settings which could be used for valid comparisons of access: having to restart the care-seeking process, abandoning it, using emergency services for primary care, and health deterioration due to delay. (C) 2014 Elsevier Ltd. All rights reserved.