Urban and Rural Differences in Health Insurance and Access to Care

Abstract

This study considers differences in access to health care and insurance characteristics between residents of urban and rural areas. Data were collected from a telephone survey of 10,310 randomly selected households in Minnesota. Sub-samples of 400 group-insured, individually insured, intermittently insured, and uninsured people, were asked about access to health care. Those with group or individual insurance were also asked about the costs and characteristics of their insurance policies. Rural areas had a higher proportion of uninsured and individually insured respondents than urban areas. Among those who purchased insurance through an employer, rural residents had fewer covered benefits than urban residents (5.1 vs 5.7, P < 0.01) and were more likely to have a deductible (80% versus 40%, P < 0.01). In spite of this, rural uninsured residents were more likely to have a regular source of care than urban residents (69% versus 51%, P < 0.01), and were less likely to have delayed care when they thought it was necessary (21% versus 32%, P < 0.01). These differences were confirmed by multivariate analysis. Rural residents with group insurance have higher out-of-pocket costs and fewer benefits. Uninsured rural residents may have better access to health care than their urban counterparts. Attempts to expand access to health care need to consider how the current structure of employment-based insurance creates inequities for individuals in rural areas as well as the burdens this structure may place on rural providers.

Spatial Distribution of Total Number of Medical Devices in Turkey: A Classification Analysis

“…25 Older literature refers to the difference between rural and urban Turkey according to the access to main health care services. 26 The traditional approaches indicate that there is a difference between rural and urban health in terms of utilization, spending, and geographic distribution of service providers. 27 Apart from access to main health care services, health technology usage between rural and urban parts of the country still remains a problem.…”

Sensible Treatment of Obesity in Rural Youth (STORY): Design and methods

“…Thus, high quality food products (i.e., fresh fruits and vegetables) can be more expensive or more difficult to obtain for families in rural areas. In addition, the extended distance needed to travel to medical providers also makes it difficult to coordinate family schedules, which ultimately affects all aspects of health care [16]. These factors add an additional level of barriers that make adopting healthier lifestyles challenging for families in rural communities.…”

Assessing Measurement Error in Medicare Coverage From the National Health Interview Survey

“…Reporting of Medicare coverage may be influenced by health care utilization, which in turn may be affected by such person-level characteristics as gender, age, marital status, race and ethnicity, educational attainment, family income, family size, citizenship status, employment status, and having additional medical coverage (Fiscella, Franks, Doescher, & Saver, 2002;Hartley, Quam, & Lurie, 1994;Huang, Shih, Chang, & Chou, 2007;Leclere, Jensen, & Biddlecom, 1994;Mentnech, Ross, Park, & Benner, 1995;Zuvekas & Taliaferro, 2003). These covariates are reported by the NHIS family respondent.…”