N13 Living in rural communities with Inflammatory Bowel Disease: Perspectives on healthcare use and access to care from patients and providers in one Canadian province
Bibliographic record
Abstract
Abstract Background Living with Inflammatory Bowel Disease (IBD) requires lifelong, repeated interactions with the healthcare system. Individuals with IBD living in rural areas are often disadvantaged with limited access to IBD-related healthcare services in their local communities which can result in poor health outcomes. Furthermore, these individuals encounter additional out of pocket expenses to travel to urban centres for care. There is limited information about the experiences of access to IBD-related care from the perspectives of patients and providers living in rural communities. The purpose of this study was to examine healthcare utilization and access to care in individuals with IBD who reside in rural areas within one Canadian province. Methods The qualitative results from a larger patient-oriented, mixed methods study will be reported. Seventeen individuals residing in rural communities from one Canadian province were recruited to participate. Fourteen individuals living with IBD and three healthcare providers were interviewed and shared their experiences on IBD-related access to care and healthcare use. Data was collected prior to the pandemic. Interview data was analyzed using thematic analysis to identify common themes. Results Many participants identified access to care challenges associated with living in rural communities. Communication, stressors and support systems, and coordination of care were identified as themes. Participants described disconnects in communication with and between healthcare providers. They suggested virtual technology was underutilized and was a cost-effective means to enhance communication. Participants experienced feelings of isolation and identified stressors while living in rural areas. They recommended the integration of formal and informal supports to ease stressors and promote mental well-being. Participants reported gaps in care and described a lack of accessible, multidisciplinary rural healthcare providers to optimize their IBD-related care and health outcomes. This lack of access to rural care resulted in frequent travel to access a variety of services. Recruitment and retention of rural care providers was identified as a strategy to enhance access to care. Conclusion Participants offered many suggestions to improve rural IBD-related care access within the healthcare system. These initiatives have great potential to increase quality of care, enhance quality of life, and reduce health system costs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.021 | 0.003 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".