Rural-urban differences in access to care among children and adolescents in the United States.

Autor: Crouch E; Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.; Rural and Minority Health Research Center, Arnold School of Public Health, Columbia, South Carolina, USA., Hung P; Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA., Benavidez G; Rural and Minority Health Research Center, Arnold School of Public Health, Columbia, South Carolina, USA., Giannouchos T; Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.; Rural and Minority Health Research Center, Arnold School of Public Health, Columbia, South Carolina, USA., Brown MJ; Department of Epidemiology and Biostatistics, Arnold School of Public Health, Columbia, South Carolina, USA.; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, South Carolina, USA.
Jazyk: angličtina
Zdroj: The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association [J Rural Health] 2024 Jan; Vol. 40 (1), pp. 200-207. Date of Electronic Publication: 2023 May 22.
DOI: 10.1111/jrh.12769
Abstrakt: Purpose: Rural children and adolescents face disproportionate challenges in access to health care services than their urban counterparts. Yet, recent evidence on disparities in access to health care between rural and urban children and adolescents has been limited. This study examines the associations of residence location with receipt of preventive care, foregone medical care, and continuity of insurance coverage among US children and adolescents.
Methods: This study used cross-sectional data from the 2019 to 2020 National Survey of Children's Health, with a final sample size of 44,679 children. Descriptive statistics, bivariate analyses, and multivariable logistic regression models were used to examine the differences in preventive care, foregone care, and continuity of insurance coverage between rural and urban children and adolescents.
Findings: Rural children had lower odds of receiving preventive care (aOR 0.64; 95% CI 0.56-0.74) and having continuous health insurance coverage (aOR 0.68; 95% CI 0.56-0.83) compared to urban children. The odds of foregone care were similar between rural and urban children. Children at every federal poverty level (FPL) less than 400% were less likely to receive preventive care, and more likely to forego care than children residing at 400% or above FPL.
Conclusions: Rural disparities in child preventive care and insurance continuity warrant ongoing surveillance and local access to care initiatives, especially for children in low-income households. Without updated public health surveillance, policymakers and program developers may not be aware of current disparities. School-based health centers are 1 avenue for meeting the unmet health care needs of rural children.
(© 2023 National Rural Health Association.)
Databáze: MEDLINE
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