Trends in Hospital Mortality for Uninsured Rural and Urban Populations, 2012‐2016
| Autor: | Lauren Elson, Karen E. Joynt Maddox, Timothy D. McBride, Abigail R. Barker, Alina A. Luke |
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| Rok vydání: | 2020 |
| Předmět: |
Rural Population
Urban Population Hospital mortality Logistic regression 03 medical and health sciences 0302 clinical medicine Rurality Humans Medicine Hospital Mortality 030212 general & internal medicine Healthcare Disparities Retrospective Studies Medically Uninsured Median income 030505 public health business.industry Mortality rate Public Health Environmental and Occupational Health Retrospective cohort study United States Health equity Household income 0305 other medical science business Demography |
| Zdroj: | The Journal of Rural Health. 37:318-327 |
| ISSN: | 1748-0361 0890-765X |
| DOI: | 10.1111/jrh.12425 |
| Popis: | PURPOSE Rural-urban health disparities have received increasing scrutiny as rural individuals continue to have worse health outcomes. However, little is known about how insurance status contributes to urban-rural disparities. This study characterizes how rural uninsured patients compare to the urban uninsured, determines whether rurality among the uninsured is associated with worse clinical outcomes, and examines how clinical outcomes based on rurality have changed over time. METHODS We conducted a retrospective cohort study of the 2012-2016 National Inpatient Sample hospital discharge data including 1,478,613 uninsured patients, of which 233,816 were rural. Admissions were broken into 6 rurality categories. Logistic regression models were used to determine the independent association between rurality and hospital mortality. FINDINGS Demographic and clinical characteristics differed significantly between rural and urban uninsured patients: rural patients were more often white, lived in places with lower median household income, and were more often admitted electively and transferred. Rurality was associated with significantly higher in-hospital mortality rates (1.44% vs 1.89%, OR 1.32, P |
| Databáze: | OpenAIRE |
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