Observational studyJournal of general internal medicine2021
Comparing Preventable Acute Care Use of Rural Versus Urban Americans: an Observational Study of National Rates During 2008-2017.
Observational study in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Risk Factors Associated with Preventable Hospitalisation among Rural Community-Dwelling Patients: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Hospital-Level Care at Home for Adults Living in Rural Settings: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Comparing Trends in Telemedicine Use and Geographic Disparities in Utilization Among Patients With Cancer in the United States.JCO oncology practice · 2026Article
- Trends in the mortality of vascular intestinal disorders in the USA: a CDC WONDER analysis.BMJ open · 2026Article
- Acute Care Utilization Patterns During Chemotherapy and Predictive Model Development at a Rural Community Cancer Center.JCO clinical cancer informatics · 2025Article
- Emergency department visits among rural and urban older adults: disparities in ambulatory and emergency care sensitive conditions.BMC health services research · 2025Article
- Year 1 of Medicare's Accountable Care Organization Realizing Equity, Access, and Community Health Model.JAMA health forum · 2025Article
- Health differences between rural and non-rural Texas counties based on 2023 County Health Rankings.BMC health services research · 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
- Early impacts of the Pennsylvania Rural Health Model on potentially avoidable utilization.Health affairs scholar · 2024Article
- THE ROLE OF HEALTH POLICY IN IMPROVING HEALTH OUTCOMES AND HEALTH EQUITY.Transactions of the American Clinical and Climatological Association · 2024Article
- Quantifying Health Outcome Disparity in Invasive Methicillin-Resistant Staphylococcus aureus Infection using Fairness Algorithms on Real-World Data.Pacific Symposium on Biocomputing. Pacific Symposium on Biocomputing · 2024Article
- Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them.PLOS global public health · 2023Article
- Association of Function, Symptoms, and Social Support Reported in Standardized Outpatient Clinic Questionnaires With Subsequent Hospital Discharge Disposition and 30-Day Readmissions.Archives of physical medicine and rehabilitation · 2022Article
- Myocardial Infarction: The Protective Role of MiRNAs in Myocardium Pathology.Frontiers in cardiovascular medicine · 2021Review
- Perceived Emergency Department Avoidance Following Virtual Provider-to-Provider Consultation: A Cross-Sectional Study.Journal of primary care & community healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundRural Americans have less access to care than urban Americans. Preventable acute care use is a marker of unmet ambulatory healthcare needs, but little is known about how such utilization has differed between rural and urban areas over time.
objectiveCompare preventable emergency department (ED) visit and hospitalization rates among rural versus urban residents over the past decade.
designObservational study using a validated algorithm to compute age-sex-adjusted rates per 100,000 individuals of preventable ED visits and hospitalizations. Differences in overall, annual, and condition-specific rates for rural versus urban residents were assessed and linear regression was used to assess 10-year trends.
settingNationwide Emergency Department Sample, National Inpatient Sample, and US Census, 2008-2017.
participantsUS adults, an annual average of 241.3 million individuals. MEASUREMENTS: Preventable ED visits and hospitalizations.
resultsCompared to urban residents, rural residents had 45% higher rates of preventable ED visits in 2008 (3003 vs. 2070 per 100,000, adjusted difference [AD]: 933; 95% CI: 928-938) and 44% higher rates of preventable ED visits in 2017 (3911 vs. 2708 per 100,000, AD: 1202; 95% CI: 1196-1208). Rural residents had 26% higher rates of preventable hospitalizations in 2008 (2104 vs. 1666 per 100,000, AD: 439; 95% CI: 434-443) and 13% higher rates in 2017 (1634 vs. 1440 per 100,000, AD: 194; 95% CI: 190-199). Preventable ED visits increased more in absolute terms in rural versus urban residents, but the percentage increase was similar (30% vs. 31%) because rural residents started at a higher baseline. Preventable hospitalizations decreased at a faster rate (22% vs. 14%) among rural versus urban residents. LIMITATIONS: Observational study; unable to infer causality.
conclusionsRural disparities in acute care use are narrowing for preventable hospitalizations but have persisted for all preventable acute care use, suggesting unmet demand for high-quality ambulatory care in rural areas.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.