Focus Group Results Focus groups were another key component of the Primary Care Needs Assessment (PCNA) process. At the end of the survey, participants were given the opportunity to indicate their interest in participating in a focus group. A total of 81 survey participants indicated they were interested/willing to participate in a focus group. Emails were sent to all of these individuals, and focus groups were scheduled at various times (mornings, afternoons, and evenings) to accommodate the schedules of as many people as possible. Of the 81 who indicated they were interested, a total of 20 signed up to attend a focus group. Ultimately, 6 focus groups were held with a total of 11 participants. Four of the participants were from urban areas, and seven were from rural areas. While the focus group participation was lower than expected, some common themes emerged across the six focus groups.
Access to Care Those in urban areas typically reported having access to multiple healthcare services – hospitals, emergency departments, urgent care facilities, primary care practices, Federally Qualified Health Centers (FQHCs), safety net clinics, health departments, pharmacies, and/or options for specialty care. Those in rural areas mentioned having access to a rural health clinic, a critical access hospital (CAH), or a health department. Some rural areas have experienced hospital closures. One participant talked about how difficult the hospital closure has been on the community and the added stress it has put on local emergency medical services (EMS). Those in rural areas are more likely to leave the county – and sometimes even the state – to access care, often traveling 30 minutes or more each way for needed services. In rural areas, the providers are often people who grew up in the community and/or have family in the community. Rural participants also mentioned that some providers who work in the community do not actually live in the community, and that creates a different dynamic between patient and provider.
Barriers to Care Insurance Status Insurance status was mentioned as a barrier in every focus group. Those with insurance may not understand their deductibles/copays or be able to afford to pay their portion of the expenses related to services and/or medications. Those without insurance have to figure out where they can go for services. Those with Medicaid/Medicare also have to figure out where they can go for services. Some providers limit the number of Medicaid/Medicare patients they take, which can impact wait times to access services. One participant expressed the concern that providers may feel less inclined to spend additional
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