Handling the Challenges: Access to Certified Hand Therapy in Mississippi.

Abstract

Objectives: Access to a certified hand therapist (CHT) plays a crucial role in enhancing postsurgical functional outcomes and reducing morbidity in complex hand surgery and trauma cases. Unfortunately, the availability of CHTs is uneven across regions, particularly in less populous states such as Mississippi. The financial and time-related burdens of traveling to a CHT to receive appropriate rehabilitation care affects patients recovering from hand surgery and hand trauma. This study investigated the accessibility of CHT services in Mississippi by analyzing physical proximity to CHTs and assessing the resultant economic implications, specifically focusing on transportation costs.

Methods: County-level distances to the nearest CHT were mapped and evaluated. The associated cost of personal vehicle transport was calculated using 2024 Internal Revenue Service standard mileage rates of $0.67/mi. Distance from a CHT and travel costs were stratified based on published 2023 Rural-Urban Continuum Codes.

Results: One-way analysis of variance revealed a significant difference in both the distance traveled to CHTs and the associated travel costs when stratified by Rural-Urban Continuum Codes (P < 0.05). On average, the distance to a CHT in Mississippi is 27.6 mi or 55.2 mi round trip, incurring a cost of $36.98 per visit. Residents of the farthest county from a CHT travel 86.4 miles or 172.8 miles round trip, however, resulting in a financial burden of $115.78 per visit to a CHT.

Conclusions: This heightened cost for individuals residing farthest away poses substantial geographic, economic, and time-related barriers to accessing CHT services. Moreover, these barriers have a pronounced impact on the well-being of patients and their families, considering the frequency of required visits for adequate rehabilitation and functional recovery, typically occurring once or twice per week over several months. This study emphasizes the urgency of addressing disparities in CHT access to ensure equity across the state.