Nearly one in five people on Medicare travel 50 or more miles one way to see a neurologist, according to research published in the September 13, 2023, online issue of Neurology, the medical journal of the American Academy of Neurology (AAN). The study, funded by the American Academy of Neurology, found that people who require specialized neurologic care for diseases such as brain cancer, amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS) travel long distances most often.
The study included over 563,000 people on Medicare who saw a neurologist at least once during the one-year study. Participants had an average age of 70. Researchers looked at age, sex, race and ethnicity and neurologic condition for each participant. During the study 14,439 neurologists provided care to participants in more than 1.2 million office visits.
To determine travel distance, researchers compared participants’ home zip codes and their neurologists’ office zip codes. Long distance was defined as 50 or more miles one way.
Over 96,000 people, or 17%, traveled long distances, with an average of 81 miles one way and an average travel time of 90 minutes.
People who did not travel long distances went an average distance of 13 miles with an average travel time of 22 minutes.
Among neurologic conditions, long‐distance travel was most common for people with brain and spinal cord cancers, with 40% of these participants traveling long distances; ALS, 30%; and MS, at 23%.
Researchers found many factors were associated with long‐distance travel. People who lived in areas with the fewest neurologists, 10 neurologists per 100,000 Medicare beneficiaries, had a three times greater chance of traveling long distance than people living in areas with the most neurologists, 50 per 100,000 Medicare beneficiaries. People who lived in rural areas had a five times greater chance of traveling long distances than people living in urban areas. Also, people who traveled long distances to see their primary care physician had a three times greater chance of long-distance travel to see a neurologist.
Nearly one-third of participants bypassed the nearest neurologist by 20 miles or more to see a neurologist, and 7% of people crossed state lines for neurologic care.
When looking at over 165,000 participants who visited a neurologist for the first time within the first three months of the study, 62,000 had at least one follow-up visit with the same neurologist. Participants who traveled long distances had a 26% decreased chance of a follow-up visit compared to those without long-distance travel.