ArticlePloS one2020
Determinants of rural-urban differences in health care provider visits among women of reproductive age in the United States.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Factors affecting women's access to primary care in the United States since the Affordable Care Act: A mixed-methods systematic review.PloS one · 2024Pooled it
- Unveiling barriers to reproductive health awareness among rural adolescents: a systematic review.Frontiers in reproductive health · 2024Pooled it
- Adherence to Obstetrician-/Gynecologist-Ordered Multi-target Stool DNA Test Screening and Follow-Up Colonoscopy: A National Multi-payer Study of US Women.Advances in therapy · 2026Article
- Abortion Provision by Family Physicians Before and After Dobbs: Trends Across Career Stages and State Restrictions.Journal of the American Board of Family Medicine : JABFM · 2026Article
- Sterilization, Infecundity, and Reproductive Autonomy in Rural, Suburban, and Urban America: Results From a National Survey.Perspectives on sexual and reproductive health · 2025Article
- Investigation of rural-urban differences in hospitalization for ambulatory care-sensitive conditions: Analysis of linked survey, hospitalization, and tax data from Canada.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Article
- Evaluation of a method to identify midwives in national provider identifier data.BMC pregnancy and childbirth · 2023Article
- Training in Residency and Provision of Reproductive Health Services Among Family Medicine Physicians.JAMA network open · 2023Observational
- Rural-Urban Differences in the Utilization of Hospital-Based Care for Women of Reproductive Age.Women's health reports (New Rochelle, N.Y.) · 2022Article
- The impact of health resource enhancement and its spatiotemporal relationship with population health.Frontiers in public health · 2022Article
- Monthly Trends in Access to Care and Mental Health Services by Household Income Level During the COVID-19 Pandemic, United States, April: December 2020.Health equity · 2021Article
- Provider-reliant contraception use among reproductive-aged women in rural Appalachian Ohio.Women's health (London, England)Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRural health disparities and access gaps may contribute to higher maternal and infant morbidity and mortality. Understanding and addressing access barriers for specialty women's health services is important in mitigating risks for adverse childbirth events. The objective of this study was to investigate rural-urban differences in health care access for women of reproductive age by examining differences in past-year provider visit rates by provider type, and quantifying the contributing factors to these findings. METHODS AND
findingsUsing a nationally-representative sample of reproductive age women (n = 37,026) from the Medical Expenditure Panel Survey (2010-2015) linked to the Area Health Resource File, rural-urban differences in past-year office visit rates with health care providers were examined. Blinder-Oaxaca decomposition analysis quantified the portion of disparities explained by individual- and county-level sociodemographic and provider supply characteristics. Overall, there were no rural-urban differences in past-year visits with women's health providers collectively (65.0% vs 62.4%), however differences were observed by provider type. Rural women had lower past-year obstetrician-gynecologist (OB-GYN) visit rates than urban women (23.3% vs. 26.6%), and higher visit rates with family medicine physicians (24.3% vs. 20.9%) and nurse practitioners/physician assistants (NPs/PAs) (24.6% vs. 16.1%). Lower OB-GYN availability in rural versus urban counties (6.1 vs. 13.7 providers/100,000 population) explained most of the rural disadvantage in OB-GYN visit rates (83.8%), and much of the higher family physician (80.9%) and NP/PA (50.1%) visit rates. Other individual- and county-level characteristics had smaller effects on rural-urban differences.
conclusionAlthough there were no overall rural-urban differences in past-year visit rates, the lower OB-GYN availability in rural areas appears to affect the types of health care providers seen by women. Whether rural women are receiving adequate specialized women's health care services, while seeing a different cadre of providers, warrants further investigation and has particular relevance for women experiencing high-risk pregnancies and deliveries.
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