Geographic barriers to medical care are widely viewed as contributors to health disparities. A 2023 US study found that travel times are increasing, specifically in rural areas. Healthcare system consolidation, physician shortages, and hospital closures may further worsen this trend. Planned Medicaid spending cuts could add further strain on rural hospitals. Travel distance is only one factor in healthcare, but its influence on outcomes and use remains unclear. Some studies suggest that longer travel times are associated with poorer access to healthcare, especially in emergency situations. Research findings are mixed: longer travel has been associated with delayed cancer diagnosis and higher mortality. But it has also been linked to higher surgical use and lower operative mortality. Other studies show no significant associations. To better understand these acceptable travel limits, Soren Mattke et al. surveyed US adults to estimate the acceptable travel times for different types of medical services.
In this survey study, participants aged ≥65 years from the nationally representative Understanding America Study (UAS) internet panel between April 23, 2025, and June 8, 2025, were eligible, and 3,390 individuals were invited to participate. Of the 3,390, 2781 individuals responded. The authors restricted the analyses to 2,762 respondents without missing covariates and matched 2,650 (mean age = 72.9±6.0 years, female = 52%, male = 48%, Non-Hispanic White = 78.5%) to a concurrent survey assessing self-reported health status, which yielded approximately 78.2% response rate for the analytical sample. Among the 2,650 participants, 51.5% of them reported an annual income of over $60,000, while 48.5% reported less than $60,000. The primary endpoints were maximum acceptable travel times for specialty care and primary healthcare, as well as one-time diagnostic services. Linear regression analysis methods were employed to examine the associations between participants’ characteristics and willingness to travel. Statistical analyses were performed using Stata, version 14.2.
Among 2,650 respondents, 98.2% reported having a primary care physician, and 85.8% had visited a medical specialist. Most participants traveled 30 minutes or less for specialty care (60.7%) and primary care (81.8%). Access to doctors did not significantly differ between metropolitan and non-metropolitan areas for specialty care, with p = 0.51, and primary care, with p = 0.09. But metropolitan residents were more likely to travel ≤30 minutes for specialty care (69.8% vs 28.9%; p <0.001) and primary healthcare (84.9% vs 70.4%; p <0.001). Approximately 83.8% (n = 2,222) of respondents drove themselves; 36.3% were sometimes accompanied. Prior travel-related problems were reported by 26.2% (n = 693) of respondents.
The median willingness to travel was 112.5 min (IQR: 67.5-202.5) for diagnostic tests, 127.5 min (IQR: 67.5-232.5) for specialty care, and 67.5 min (IQR: 37.5-112.5) for primary care. Overall, 60.3% (n = 1597) of respondents were willing to travel for at least one hour for primary care centers, and 84.4% (n = 2237) for specialty care, as well as 82.5% (n = 2185) for diagnostic services. Higher education and income were associated with a longer willingness to travel. In contrast, self-reported fair/poor health, metropolitan residence, and prior difficulties traveling to medical appointments were linked to shorter willingness to travel times. Additionally, increasing age was modestly associated with reduced willingness to travel for specialty care appointments.
This study’s limitations include reliance on stated preferences rather than actual behavior, limited representation of racial and ethnic minority participants, restricted generalizability to younger populations and other countries, and lack of data on emergency care, visit frequency, and wait times.
In conclusion, this study’s findings suggest that older US adults are willing to travel substantial distances for routine care. These results challenge assumptions that certain travel times are prohibitive and may inform policy decisions amid ongoing healthcare system consolidation. Future research should examine additional types of services and different populations.
Reference: Burke J, Ozawa T, Liu Y, Ye W, Mattke S. Willingness of Older Adults to Travel for Medical Care. JAMA Netw Open. 2026;9(2):e2560280. doi:10.1001/jamanetworkopen.2025.60280
