How far will patients go for primary care? Survey finds travel thresholds vary

A national survey of U.S. adults age 50 and older found that most say they could tolerate longer travel to reach a primary care physician before delaying or skipping care, according to findings published November 24 in JAMA Network Open. But willingness to travel farther was not shared evenly — income level, race, education and where respondents live all strongly influenced whether people felt they could take on more time to get to appointments.

The survey of 4,046 adults found that most can currently reach a primary care office in 30 minutes or less.

When asked how long they’d be willing to travel before putting off care, the average threshold rose to nearly 60 minutes.

Still, respondents with lower income, those identifying as racial or ethnic minorities, and adults living in urban areas were less likely to say they would tolerate longer travel compared with higher‑income, White or non‑urban adults.

Short trips are the norm

Among respondents with a usual primary care physician, 82.2% said their current travel time is 30 minutes or less, and only 2.6% travel more than an hour.

The average was 20 minutes overall, including 19 minutes in urban areas, 18 minutes in suburban areas and 27 minutes in rural regions. By comparison, the average maximum travel time respondents said they would accept before delaying or foregoing care was 53 minutes.

In all, 77% said they would increase travel time rather than defer care, with an average willingness to add about 33 minutes beyond their current trip.

Income, race and geography influence willingness

The analysis used logistic regression to identify characteristics associated with willingness to increase travel time. Several factors stood out.

• Higher income: Adults earning $100,000 or more had considerably greater odds of accepting longer travel when compared with respondents earning less than $40,000.
• Race and ethnicity: Black and Hispanic respondents were less likely than White respondents to say they’d extend their trip.
• Education: Respondents with at least a bachelor’s degree showed higher willingness.
• Geography: Suburban and rural/other residents showed greater willingness than adults living in urban areas.
• Current travel time: The longer someone already travels, the less likely they were to take on additional time.

Age and income were among the strongest predictors.

At the upper end, predicted willingness reached 83% among respondents with annual household income of $100,000 or more, compared with 70% in households earning under $40,000.

Travel burden could hit vulnerable groups hardest

Older adults in the U.S. generally enjoy strong access to a primary care physician — 96.4% in the survey reported having one — but rising travel demands could change that.

Researchers ultimately concluded that, if travel demands grow, primary care use may fall among groups already facing structural disadvantages, which includes those with lower income or education, racial and ethnic minority populations, people living in urban areas and individuals who already travel longer distances for care.

The research was limited by its reliance on stated preferences, which may not always mirror real‑world decisions, and did not capture insurance information. Even so, the findings point to population groups most at risk of reduced access if longer travel becomes common.

Policy considerations

Interventions aimed at reducing travel burdens — whether that be through improved transit, additional clinical capacity, alternative care locations or home-based services — should account for disparities in who can realistically tolerate longer trips.

The authors did caution that willingness alone does not guarantee follow-through, especially among groups that already face access barriers.