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Local Health Care Limited for Rural Children

More than half of all children in the most rural counties of the United States are hospitalized in more urban areas, according to a new study //by HHS Agency for Healthcare Research and Quality and other authors published in the September-October 2006 issue of Ambulatory Pediatrics.

The study, which was led by AHRQ’s Frances Chevarley, Ph.D., analyzed access to and quality of health care, health status, and other measures for children in four types of counties--- large metropolitan, small metropolitan, micropolitan, and non-core. Micropolitan and non-core, which is the most rural type of area, make up non-metropolitan (rural) counties. The researchers based their findings on data from AHRQ’s Medical Expenditure Panel Survey and Healthcare Cost and Utilization Survey.

Among the study’s findings are that:

o Children in non-core counties were more likely to be hospitalized for potentially preventable conditions, such as gastroenteritis, bacterial pneumonia, and dehydration, than children in small and large metropolitan counties.

o Non-core and micropolitan children had an emergency department visit rate larger than that observed for children from large metropolitan counties (17.5 percent and 19 percent vs. 12 percent).

o The proportion of children with at least one dental visit was smaller in large metropolitan and non-core counties (43 percent and 40 percent) than in small metropolitan counties (47 percent).

When the researchers looked at measures such as income and insurance status, they found:

o Children in rural counties (both micropolitan and non-core) tended to be poorer than those in metropolitan counties (both large and small metropolitan).

o White, non-Hispanic children outside of large metropolitan counties tended to rely more on public coverage such as Medicaid (18 percent in small metropolitan, 23 percent in micropolitan, and 25.5 percent in non-core), than ch ildren in large metropolitan counties (12 percent).

o A larger portion of Hispanic children were uninsured in large metropolitan counties (16 percent) than in small metropolitan counties (11 percent).

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