ArticleHealth services research2022
Definition and categorization of rural and assessment of realized access to care.
Article in Health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Rural-Urban Disparities in Colorectal Cancer Screening, Diagnosis, Treatment, and Survivorship Care: A Systematic Review and Meta-Analysis.The oncologist · 2024Pooled it
- The obesity-related chronic disease index (ORCDi), a novel composite metric to quantify ORCD burden: an ecological study across U.S. census tracts.Lancet regional health. Americas · 2026Article
- Availability and Access to Palliative Sedation Medications in Ecuador: A National Survey of Palliative Care Physicians.International journal of environmental research and public health · 2026Article
- Community-level contextual factors associated with lung cancer: a hot spot analysis.Cancer causes & control : CCC · 2026Article
- Cancer clinical trial recruitment for patients from rural areas: a scoping review.International journal for equity in health · 2026Article
- Outpatient Care Fragmentation and Patient Satisfaction With Care.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Testing and evaluating updated variants of the rurality index for Japan: a nationwide methodological study.BMJ open · 2026Article
- Geospatial Disparities in Access to Outpatient Physical and Occupational Therapy Services in Texas: Implications for Health Equity and Rehabilitation Workforce Policy.International journal of environmental research and public health · 2026Article
- Impact of Medicaid Enrollment Timing on Tumor Stage at Diagnosis and Survival in Breast, Colorectal, and Lung Cancer.Healthcare (Basel, Switzerland) · 2026Article
- Outcomes Among Patients With Colon Cancer Living in Neighborhoods With Persistent Poverty.JAMA network open · 2026Article
- Rural-urban disparities in primary care and geographic continuity of care for children with medical complexity.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Mapping the Availability of Rehabilitation Providers Using Public Licensure and Population Data for a Geographic Information System-Based Approach to Workforce Planning: Cross-Sectional Feasibility Study.JMIR formative research · 2025Article
- Access to pediatric trauma centres in Canada: a population-based retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- A novel approach to incorporate frontier areas into urban-rural geographic classifications: Integrated Metropolitan-to-Frontier Area Codes.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Video and Telephone Telehealth Use and Web-Based Patient Portal Activation Among Rural-Dwelling Patients: Retrospective Medical Record Review and Policy Implications.Journal of medical Internet research · 2025Article
- The Role of Rurality, Travel Time, and Neighborhood Socioeconomics on Patterns of Adjuvant Therapy Receipt among Patients with Endometrial Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Diagnostic disparities in inborn errors of immunity: From clinical suspicion to diagnosis.The journal of allergy and clinical immunology. Global · 2025Article
- Deconstructing rurality to better "place" health data.International journal of geographical information science : IJGIS · 2025Article
- Health behaviors, and beliefs about health behaviors and cancer risk, among US cancer survivors: a HINTS-SEER study.Cancer survivorship research & care · 2025Article
- Overview of Alzheimer's Disease Neuroimaging Initiative and future clinical trials.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo examine how three measures of realized access to care vary by definitions and categorizations of "rural". DATA SOURCES: Health Information National Trends Survey (HINTS) data, a nationally representative survey assessing knowledge of health-related information, were used. Participants were categorized by county-based Urban Influence Codes (UICs), Rural-Urban Continuum Codes (RUCCs), and census tract-based Rural-Urban Commuting Area (RUCAs). STUDY
designThree approaches were used across categories of UICs, RUCCs, and RUCAs: (1) non-metropolitan/metropolitan, (2) three-group categorization based upon population size, and (3) three-group categorization based on adjacency to metropolitan areas. Wald Chi-square tests evaluated differences in sociodemographic variables and three measures of realized access across three of Penchansky's "A's of access" and approaches. The three outcome measures included: having a regular provider (realized availability), self-reported "excellent" quality of care (realized acceptability), and self-report of the provider "always" spending enough time with you (provider attentiveness-realized accommodation). The average marginal effects corresponding to each outcome were calculated. DATA COLLECTION/EXTRACTION
methodsN/A PRINCIPAL
findingsAll approaches indicated comparable variation in sociodemographics. In all approaches, RUCA-based categorizations showed differences in having a regular provider (e.g., 68.9% of non-metropolitan and 64.4% of metropolitan participants had a regular provider). This association was attenuated in multivariable analyses. No rural-urban differences in quality of care were seen in unadjusted or adjusted analyses regardless of approach. After adjustment for covariates, rural respondents reported greater provider attentiveness in some categorizations of rural compared with urban (e.g., non-metropolitan respondents reported 6.03 percentage point increase in probability of having an attentive provider [CI = 0.76-11.31%] compared with metropolitan).
conclusionsOur findings underscore the importance of considering multiple definitions of rural to understand access disparities and suggest that continued research is needed to examine the interplay between potential and realized access. These findings have implications for federal funding, resource allocation, and identifying health disparities.
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