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Report: Rural Areas Have Lower-Quality Health Care Than Suburbs and Cities

By Rebecca Adams, CQ HealthBeat Associate Editor

July 27, 2011 -- Rural physicians and consumers rate the quality of care in their towns lower than people in urban and suburban areas, and their impressions are validated by data in a new report released early Wednesday by UnitedHealth Group.

In the 84-page report, researchers found that in 70 percent of insurance markets, using a set of objective measurements, the quality of care scored lower in rural areas than in cities.

The report also found that there are only 65 primary care doctors per 100,000 rural Americans, as compared with 105 primary care physicians per 100,000 urban and suburban Americans. Rural areas have fewer than half the number of surgeons and other specialists per capita than are in urban and suburban areas.

As part of the report, Harris Interactive surveyed 2,000 patients and 1,006 primary physicians nationwide. The survey found that doctors in rural areas were more likely than their urban and suburban counterparts to say diabetes, hypertension, heart problems, cancer, drug abuse, and teen pregnancy are major health problems affecting their communities.

More than 30 percent of rural primary care physicians said in the survey that it is difficult to find specialists to serve their patients, compared with fewer than 10 percent of urban and suburban primary care physicians.

The survey was conducted in May and has a margin of error among the physicians of plus or minus 3.09 percentage points. For the total consumer population, the margin of error was plus or minus 2.19 percentage points.

The report also includes a new analysis by The Lewin Group, which projects an increase of around 8 million insured rural residents by 2019 due to the health care overhaul’s Medicaid expansion and state insurance exchanges. Since some rural residents will have other sources of insurance, the net rural coverage expansion is expected to be about 5 million people, the report said.

The study’s authors conclude that telemedicine may be a good way to prevent access problems, especially in rural areas, as people gain coverage as called for in the health care law (PL 111-148, PL 111-152).

UnitedHealth study (pdf)

Rebecca Adams can be reached at [email protected].

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