The Development and Pilot-Testing of an Instrument to Measure Out-Of-Pocket Costs for Rural Patients Accessing Surgical Services in British Columbia

From our focus groups and investigations in to other research projects, we found that themes highlighted out-of-pocket costs of:

• Transportation
• accommodation and meals
• Traveling with a companion
• Lost wages
• Child/animal care

From our survey, we found that:

• On average, rural residents pay $2,234 per person on travel related out-of-pocket spending for health.
• The majority of respondents reported difficulty in paying for the costs of accessing care outside their community.
• For many respondents, time spent away from home meant losing out on wages.
• Very few respondents received any type of system-level financial support to help cover costs.
• Those who reported spending more on traveling for health care also reported experiencing higher levels of stress and anxiety.
• Higher-income respondents experienced less stress on average.

These findings underscore just how significant traveling for health care is for rural residents, both financially as well as psychologically and emotionally. Low-wage, elderly and other marginalized rural residents are particularly impacted by the costs of traveling, with few supports available to them.

Overall, this study closes the knowledge gap about out-of-pocket costs for rural residents accessing health services in BC.