Associations of Provider-to-Population Ratios and Population Health by County-Level Rurality
| Autor: | Jeri L. Bigbee, Bronwyn E. Fields, Janice F. Bell |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Gerontology
education.field_of_study 030505 public health business.industry Population Public Health Environmental and Occupational Health Health services research Population health Birth rate 03 medical and health sciences 0302 clinical medicine Years of potential life lost Rurality Health care Medicine 030212 general & internal medicine Rural area 0305 other medical science education business Demography |
| Zdroj: | The Journal of Rural Health. 32:235-244 |
| ISSN: | 0890-765X |
| DOI: | 10.1111/jrh.12143 |
| Popis: | Purpose To explore the relationship between provider-to-population ratios, rurality and population health in the United States using counties as the unit of analysis. Method Population ratios for registered nurses (RNs), primary care physicians, and dentists were included in multivariable regression analyses. Population health indices assessed were premature death rate, self-rated health, teen birth rate, and mammography screening rate. Findings County levels of health and health care providers per capita declined as rurality increased. In adjusted regression models, the highest RN-to-population ratio was associated with significantly better health measures in most urban/rural categories, with the magnitude of these associations generally increasing as rurality increased. In the smallest rural counties, the highest RN-to-population quartile was associated with 1,655 fewer years of potential life lost (YPLL), 2% lower rates of poor or fair health, 11/1,000 fewer teen births, and 6% more mammography screening relative to the lowest quartile. For primary care physicians, more significant associations were found in medium and small rural counties where the highest quartile was associated with 1,482 fewer YPLL, 3% lower rates of poor or fair health, 7/1,000 fewer teen births, and 4% more mammography screening. The highest quartile of dentist-to-population ratio was generally associated with lower rates of premature death and poor or fair health in urban, large-, and medium-sized rural counties, but not in small rural counties. Conclusions The consistency of the results by provider type suggests that the supply of health care professionals, particularly in rural areas, positively impacts the health of the population. |
| Databáze: | OpenAIRE |
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