Rural Consumers in Kansas and Across US Face Less Access To Care After Hospital Closures

By Consumers For Quality Care, on July 12, 2019

As rural hospitals across the country close, patients have had to find an alternative plan for their treatments, Kaiser Health News reports. Karen Endicott-Coyan, a 65 year-old woman with multiple myeloma, has to drive an hour from her home in Kansas to seek treatment.

In 2018, Mercy Hospital Fort Scott faced possible closure and the hospital’s leadership did everything they could to preserve the most basic health services. The hospital’s president was able to keep the ER and four outpatient clinics running. The hospital’s oncology unit, which requires specialists and specialty drugs and equipment, had to close. Now, the area’s cancer patients face long drives to receive care. Consumers from the Fort Scott area, like Endicott-Coyan, must drive 50-60 miles away to facilities in Chanute or Parsons. Endicott-Coyan travels with a friend in case she is too sick after her treatments to drive herself home.

For Endicott-Coyan and dozens of other cancer patients, the distance meant new challenges getting lifesaving treatment. “You have a flat tire, and there is nothing out here,” Endicott-Coyan said, waving her arm toward the open sky and the pastures dotted with black Angus and white-faced Hereford cattle on either side of the shoulderless, narrow highway she now must drive to get to her chemo appointment.

Care to Share, a support group for Fort Scott patients with cancer, meets in what used to be a Mercy Hospital outpatient clinic. The group has tried to meet the community’s needs by providing patients with nutritional supplements, gas vouchers and emotional support. Mercy Hospital Fort Scott’s oncology unit was serving nearly 200 patients and roughly 40 percent were receiving chemotherapy treatment.

Lavetta Simmons, one of the support group’s founders, said she will have to raise more money to help people pay for gas so they can drive farther to treatments. Last year, in this impoverished corner of southeastern Kansas, Care to Share spent more than $17,000 providing gas money to area residents who had to travel to the Mercy hospital or farther away for care.

A recent survey from the American Society of Clinical Oncology (ASCO) found that rural cancer patients on average spend 66 percent more time traveling to and from treatment than urban patients. While nearly one in five Americans live in rural areas, only 7 percent of oncologists practice in rural areas, according to ASCO.

Additionally, rural patients are more likely to die from cancer, according to a 2017 CDC report, which found that rural cancer patients had 180 deaths per 100,000 compared to 158 deaths for metropolitan patients.

The discrepancy is partly because habits like smoking are more common among rural residents, but the risk of dying goes beyond that, said Jane Henley, a CDC epidemiologist and lead author of the report. “We know geography can affect your risk factors, but we don’t expect it to affect mortality.”

In a recent survey, 23 percent of rural consumers who reported skipping medical care said it was too far away or too difficult to get to. Endicott-Coyan and other Fort Scott residents are now grappling with how to receive care from more distant facilities.

Back in the car, Palmer took the wheel and Endicott-Coyan began planning for future cancer treatments in the void left by Mercy Hospital Fort Scott’s closure. “I put a note on Facebook today and said, ‘OK, I have drivers for the rest of February; I need drivers for March!’”