Context: Patients in rural areas may use less medical care than those living in urban areas. This could be due to differences in travel distance and time and a utilization of a different mix of generalists and specialists for their care.
Purpose: To compare the travel times, distances, and physician specialty mix of all Medicare patients living in Alaska, Idaho, North Carolina, South Carolina, and Washington.
Methods: Retrospective design, using 1998 Medicare billing data. Travel time was determined by computing the road distance between 2 population centroids: the patient's and the provider's zone improvement plan codes.
Findings: There were 2,220,841 patients and 39,780 providers in the cohort, including 6,405 (16.1%) generalists, 24,772 (62.3%) specialists, and 8,603 (21.6%) nonphysician providers. There were 20,693,828 patient visits during the study. The median overall 1-way travel distance and time was 7.7 miles (interquartile range 1.9-18.7 miles) and 11.7 minutes (interquartile range 3.0-25.7 minutes). The patients in rural areas needed to travel 2 to 3 times farther to see medical and surgical specialists than those living in urban areas. Rural residents with heart disease, cancer, depression, or needing complex cardiac procedures or cancer treatment traveled the farthest. Increasing rurality was also related to decreased visits to specialists and an increasing reliance on generalists.
Conclusions: Residents of rural areas have increased travel distance and time compared to their urban counterparts. This is particularly true for rural residents with specific diagnoses or those undergoing specific procedures. Our results suggest that most rural residents do not rely on urban areas for much of their care.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1748-0361.2006.00022.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Understanding the association between urban noise and nighttime light in China.
Sci Rep
December 2024
School of Architecture and Urban-Rural Planning, Fuzhou University, Fuzhou, 350108, China.
Nighttime light data partially reflects the process of urban modernization and its reaction to urban scale, but its correlation with noise remains unclear, especially over a long-term time series, remains unclear. To address this gap, we examine 31 provincial capital cities and municipalities in China as the study area, utilizing noise monitoring data and nighttime light data to explore their relationship in urban areas from 2012 to 2021. The results show that: (1) During the study period, the regional environmental noise and night light index of 31 major cities exhibited a consistent upward trend, with the average equivalent sound level of environmental noise in most urban areas fluctuating between 50.
View Article and Find Full Text PDFChanges in and prediction of land carrying capacity in Fujian Province from a dietary nutrition perspective.
Sci Rep
December 2024
College of Economics and Management, Fujian Agriculture and Forestry University, Fuzhou, 350002, Fujian, China.
Resources and land carrying capacity are vital to the survival and development of human society and form the foundation for ensuring food security. However, evaluating land carrying capacity solely based on grain production is overly simplistic. A comprehensive assessment from the perspective of dietary nutrition is needed to more accurately reflect the actual carrying capacity of land.
View Article and Find Full Text PDFA precision agriculture solution for water stress estimation in Hass avocado farms in Colombia.
Sci Rep
December 2024
Department of Biomedical Engineering, University of Los Andes, Bogotá, Colombia.
Agriculture 4.0 technologies continue to see low adoption among small and medium-sized farmers, primarily because these solutions often fail to account for the specific challenges of rural areas. In this work, we propose and implement a design methodology to develop a Precision Agriculture solution aimed at assisting farmers in managing water stress in Hass avocado crops.
View Article and Find Full Text PDFNon-adherence to antenatal iron supplementation and its determinants among pregnant women in 35 sub-saharan African countries: a generalized linear mixed-effects modeling with robust Poisson regression analysis.
BMC Pregnancy Childbirth
December 2024
Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Background: Despite the integration of iron supplementation into routine antenatal care programs as a nutritional intervention to prevent anemia in pregnant women, the use of this supplement for the recommended duration remains low in sub-Saharan Africa (SSA). Evidence on maternal compliance with iron supplementation at the SSA level is lacking and most of the previous studies have been limited to specific geographic areas. Therefore, the current study used large population survey data from 35 SSA countries to estimate the pooled prevalence of non-adherence and its determinants.
View Article and Find Full Text PDFSeroprevalence of canine distemper virus antibodies in free-roaming dogs in Cambodia.
Vet J
December 2024
Queensland Alliance for One Health Sciences, School of Veterinary Sciences, The University of Queensland, Gatton, Australia.
Canine distemper virus (CDV) can infect a wide range of mammalian carnivores and can cause severe illness and death. Domestic dogs may be an important source of this virus for endangered wild carnivores. The objective of this study was to establish the presence of CDV in rural areas of Cambodia bordering three established protected habitats, and to determine the seroprevalence of CDV in free-roaming dogs inhabiting these areas.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!