ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2022
Trend in rural-urban disparities in access to outpatient mental health services among US adults aged 18-64 with employer-sponsored insurance: 2005-2018.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Differential burden of five major mental disorders in the United States across the COVID-19 pandemic.European archives of psychiatry and clinical neuroscience · 2026Article
- Depression and Anxiety Risk in Children With Intellectual Developmental Disorder.JAMA network open · 2026Article
- Adult Community Perspectives on Improving Rural Youth Access to Mental Health Services: A Participatory Group Concept Mapping Study.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Trajectories of antidepressant dispensing among privately insured transgender people in the United States.Scientific reports · 2026Article
- Trends in bipolar disorder-related mortality in the United States, 1999-2023: A CDC WONDER database analysis.International journal of bipolar disorders · 2026Article
- Assessment of barriers to accessing mental health services in rural or remote areas using a socio-ecological resilience framework: a scoping review.International journal of mental health systems · 2026Review
- Patient-centered burdens and economic outcomes among patients who are veterans, people with intellectual and developmental disabilities, and people living in rural areas and their caregivers: a scoping review.Frontiers in public health · 2026Article
- Co-Design with Rural Adolescents to Inform a School-Based Physical Activity and Social Media Literacy Intervention: A Qualitative Study.International journal of environmental research and public health · 2025Article
- Trends in mental health care utilization in rural and nonrural areas, 2019-2023.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- MENTAL HEALTH STATUS AND THIRD PLACES USE AMONG RURAL WORKING-AGE ADULTS IN THE UNITED STATES.Rural society · 2025Article
- Rural Suicide: Demographics, Causes, and Treatment Implications.Community mental health journal · 2025Article
- Rural-urban differences in out-of-network treatment initiation and engagement rates for substance use disorders.Health services research · 2024Article
- Assessing prenatal and early childhood social and environmental determinants of health in the HEALthy Brain and Child Development Study (HBCD).Developmental cognitive neuroscience · 2024Article
- Association between immigrant concentration and mental health service utilization in the United States over time: A geospatial big data analysis.Health & place · 2023Article
- Inequality of opportunity in outpatient expenditure among the elderly with multimorbidity: evidence from China.International journal for equity in health · 2023Article
- Association of Race and Other Social Determinants of Health With HIV Pre-Exposure Prophylaxis Use: A County-Level Analysis Using the PrEP-to-Need Ratio.AIDS education and prevention : official publication of the International Society for AIDS Education · 2022Article
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Authors and funding
4 authors.
Funding
Abstract
purposeThis study estimates the rural-urban differences in outpatient service utilization and expenditures for depression, anxiety disorder, and substance use disorder, and the evolving mental health provider mix for privately insured US adults aged 18-64 during 2005-2018.
methodsWe used the IBM MarketScan Commercial Claims and Encounters Database for individuals covered by employer-sponsored health insurance, from 2005 to 2018, with a yearly total number of beneficiaries ranging from 17.5 to 53.1 million. Claims for nonelderly adults with mental health and substance abuse coverage are included. Outcomes include rates of outpatient service utilization for depression, anxiety disorder, and substance use disorder; counts of outpatient visits; expenditure and share of the out-of-pocket cost; and the mental health services provider mix.
findingsRural enrollees were less likely than urban enrollees to use outpatient mental health services for depression by 1.2% (percentage points) in 2005 and 0.6% in 2018. Among those who used outpatient mental health services, rural enrollees had fewer outpatient visits than their urban counterparts (difference: 1.8-2.4 visits for depression, 1.2-1.7 visits for anxiety disorder, and 0.7-2.1 visits for substance use disorder). Rural patients paid less per year for mental health outpatient visits of the 3 conditions but incurred a higher share of out-of-pocket expenses. Rural and urban patients differ in the mix of mental health providers, with rural enrollees relying more on primary care providers than urban enrollees.
conclusionsRural-urban disparities in access to mental health services persist during 2005-2018 among a population with private insurance.
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