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<!DOCTYPE html> <html lang="en" class="no-js"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0, user-scalable=yes"> <title>Trends in access to care among rural patients served at HRSA鈥恌unded health centers</title> <meta id="meta-title" property="citation_title" content="Trends in access to care among rural patients served at HRSA鈥恌unded health centers"/> <meta id="og-title" property="og:title" content="Trends in access to care among rural patients served at HRSA鈥恌unded health centers"/> <meta name="twitter:widgets:autoload" content="off"/> <meta name="twitter:dnt" content="on"/> <meta name="twitter:widgets:csp" content="on"/> <meta name="google-site-verification" content="lQbRRf0vgPqMbnbCsgELjAjIIyJjiIWo917M7hBshvI"/> <meta id="meta-abstract" name="citation_abstract" content="PurposeNearly one-fifth of Americans live in rural areas and experience multiple socioeconomic and health disparities. Health Resources and Services Administration (HRSA)-funded health centers (HCs) provide comprehensive primary care in rural communities. However, no prior research has examined trends in access to care in rural HC patients. We examined the change in access to care among patients served at rural HRSA-funded HCs in the United States between 2009 and 2014.MethodsWe compared patients by year to examine measures of access using multilevel generalized structural equation logistic regression models with random effects. We used the 2009 and 2014 cross-sectional Health Center Patient Surveys and identified 2,625 adult rural HC patients. Dependent variables were subjective (unmet need/delay in medical care, mental health, dental care, and prescription medications) and objective measures (preventive care and other health care utilization) in access to care. Our independent variable of interest was time, comparing access in 2009 and 2014.ResultsRural HC patients reported higher predicted probability of influenza vaccine receipt (37% vs 51%), and lower unmet (25% vs 14%) and delayed medical care (36% vs 18%) between 2009 and 2014. Any emergency department visits in the last year increased (32% vs 46%) and mammogram (70% vs 55%) and Pap test (83% vs 72%) screening rates decreased.ConclusionsObserved increases in access to care among rural HC patients are positive developments but the challenges to access care still persist. Remote services, such as telehealth, could be cost-effective means of improving access to care among rural patients with limited provider supply."/> <meta id="meta-description" name="description" content="Author(s): Pourat, Nadereh; Lu, Connie; Chen, Xiao; Zhou, Weihao; Hair, Brionna; Bolton, Joshua; Sripipatana, Alek | Abstract: PurposeNearly one-fifth of Americans live in rural areas and experience multiple socioeconomic and health disparities. Health Resources and Services Administration (HRSA)-funded health centers (HCs) provide comprehensive primary care in rural communities. However, no prior research has examined trends in access to care in rural HC patients. We examined the change in access to care among patients served at rural HRSA-funded HCs in the United States between 2009 and 2014.MethodsWe compared patients by year to examine measures of access using multilevel generalized structural equation logistic regression models with random effects. We used the 2009 and 2014 cross-sectional Health Center Patient Surveys and identified 2,625 adult rural HC patients. Dependent variables were subjective (unmet need/delay in medical care, mental health, dental care, and prescription medications) and objective measures (preventive care and other health care utilization) in access to care. Our independent variable of interest was time, comparing access in 2009 and 2014.ResultsRural HC patients reported higher predicted probability of influenza vaccine receipt (37% vs 51%), and lower unmet (25% vs 14%) and delayed medical care (36% vs 18%) between 2009 and 2014. Any emergency department visits in the last year increased (32% vs 46%) and mammogram (70% vs 55%) and Pap test (83% vs 72%) screening rates decreased.ConclusionsObserved increases in access to care among rural HC patients are positive developments but the challenges to access care still persist. Remote services, such as telehealth, could be cost-effective means of improving access to care among rural patients with limited provider supply."/> <meta id="og-description" name="og:description" content="Author(s): Pourat, Nadereh; Lu, Connie; Chen, Xiao; Zhou, Weihao; Hair, Brionna; Bolton, Joshua; Sripipatana, Alek | Abstract: PurposeNearly one-fifth of Americans live in rural areas and experience multiple socioeconomic and health disparities. Health Resources and Services Administration (HRSA)-funded health centers (HCs) provide comprehensive primary care in rural communities. However, no prior research has examined trends in access to care in rural HC patients. We examined the change in access to care among patients served at rural HRSA-funded HCs in the United States between 2009 and 2014.MethodsWe compared patients by year to examine measures of access using multilevel generalized structural equation logistic regression models with random effects. We used the 2009 and 2014 cross-sectional Health Center Patient Surveys and identified 2,625 adult rural HC patients. Dependent variables were subjective (unmet need/delay in medical care, mental health, dental care, and prescription medications) and objective measures (preventive care and other health care utilization) in access to care. Our independent variable of interest was time, comparing access in 2009 and 2014.ResultsRural HC patients reported higher predicted probability of influenza vaccine receipt (37% vs 51%), and lower unmet (25% vs 14%) and delayed medical care (36% vs 18%) between 2009 and 2014. Any emergency department visits in the last year increased (32% vs 46%) and mammogram (70% vs 55%) and Pap test (83% vs 72%) screening rates decreased.ConclusionsObserved increases in access to care among rural HC patients are positive developments but the challenges to access care still persist. Remote services, such as telehealth, could be cost-effective means of improving access to care among rural patients with limited provider supply."/> <meta id="og-image" property="og:image" content="https://escholarship.org/images/escholarship-facebook2.jpg"/> <meta id="og-image-width" property="og:image:width" content="1242"/> <meta id="og-image-height" property="og:image:height" content="1242"/> <meta id="meta-author0" name="citation_author" content="Pourat, Nadereh"/> <meta id="meta-author1" name="citation_author" content="Lu, Connie"/> <meta id="meta-author2" name="citation_author" content="Chen, Xiao"/> <meta id="meta-author3" name="citation_author" content="Zhou, Weihao"/> <meta id="meta-author4" name="citation_author" content="Hair, Brionna"/> <meta id="meta-author5" name="citation_author" content="Bolton, Joshua"/> <meta id="meta-author6" name="citation_author" content="Sripipatana, Alek"/> <meta id="meta-publication_date" name="citation_publication_date" content="2022-09-01"/> <meta id="meta-doi" name="citation_doi" content="10.1111/jrh.12626"/> <meta id="meta-journal_title" name="citation_journal_title" content="The Journal of Rural Health"/> <meta id="meta-issn" name="citation_issn" content="0890-765X"/> <meta id="meta-volume" name="citation_volume" content="38"/> <meta id="meta-issue" name="citation_issue" content="4"/> <meta id="meta-firstpage" name="citation_firstpage" content="970"/> <meta id="meta-lastpage" name="citation_lastpage" content="979"/> <meta id="meta-online_date" name="citation_online_date" content="2022-03-03"/> <link rel="canonical" href="https://escholarship.org/uc/item/6fg3t0z2"/> <link rel="stylesheet" href="/css/main-62e3023ddd136de2.css"> <link rel="resource" type="application/l10n" href="/node_modules/pdfjs-embed2/dist/locale/locale.properties"> <noscript><style> .jsonly { display: none } </style></noscript>   <script> var _paq = window._paq = window._paq || []; 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</li><li><a href="/search/?q=author%3ALu%2C%20Connie">Lu, Connie</a>; </li><li><a href="/search/?q=author%3AChen%2C%20Xiao">Chen, Xiao</a>; </li><li><a href="/search/?q=author%3AZhou%2C%20Weihao">Zhou, Weihao</a>; </li><li><a href="/search/?q=author%3AHair%2C%20Brionna">Hair, Brionna</a>; </li><li><a href="/search/?q=author%3ABolton%2C%20Joshua">Bolton, Joshua</a>; </li><li class="c-authorlist__end"><a href="/search/?q=author%3ASripipatana%2C%20Alek">Sripipatana, Alek</a> </li><li><a class="c-authorlist__list-more-link">et al.</a></li></ul></div><div class="c-pubinfo"><h2 class="c-pubinfo__location-heading">Published Web Location</h2><a class="c-pubinfo__link" href="https://onlinelibrary.wiley.com/doi/10.1111/jrh.12626">https://onlinelibrary.wiley.com/doi/10.1111/jrh.12626</a><div class="c-pubinfo__statement">No data is associated with this publication.</div></div><div class="c-tabs"><div class="c-tabs__tabs"><button class="c-tabs__button-more" aria-label="Show all tabs">...</button><button class="c-tabs__button--active">Main Content</button><button class="c-tabs__button">Metrics</button><button class="c-tabs__button">Author & Article Info</button></div><div class="c-tabs__content"><div class="c-tabcontent"><a name="article_abstract"></a><details class="c-togglecontent" open=""><summary>Abstract</summary><div class="c-clientmarkup"><p><h3>Purpose</h3>Nearly one-fifth of Americans live in rural areas and experience multiple socioeconomic and health disparities. Health Resources and Services Administration (HRSA)-funded health centers (HCs) provide comprehensive primary care in rural communities. However, no prior research has examined trends in access to care in rural HC patients. We examined the change in access to care among patients served at rural HRSA-funded HCs in the United States between 2009 and 2014.<h3>Methods</h3>We compared patients by year to examine measures of access using multilevel generalized structural equation logistic regression models with random effects. We used the 2009 and 2014 cross-sectional Health Center Patient Surveys and identified 2,625 adult rural HC patients. Dependent variables were subjective (unmet need/delay in medical care, mental health, dental care, and prescription medications) and objective measures (preventive care and other health care utilization) in access to care. Our independent variable of interest was time, comparing access in 2009 and 2014.<h3>Results</h3>Rural HC patients reported higher predicted probability of influenza vaccine receipt (37% vs 51%), and lower unmet (25% vs 14%) and delayed medical care (36% vs 18%) between 2009 and 2014. Any emergency department visits in the last year increased (32% vs 46%) and mammogram (70% vs 55%) and Pap test (83% vs 72%) screening rates decreased.<h3>Conclusions</h3>Observed increases in access to care among rural HC patients are positive developments but the challenges to access care still persist. Remote services, such as telehealth, could be cost-effective means of improving access to care among rural patients with limited provider supply.</p></div><p class="o-well-colored">Many UC-authored scholarly publications are freely available on this site because of the UC's <a href="https://osc.universityofcalifornia.edu/open-access-at-uc/open-access-policy/">open access policies</a>. <a href="https://help.escholarship.org/support/tickets/new">Let us know how this access is important for you.</a></p></details><div><div class="c-viewexternal"><button class="c-viewexternal__action">View on External Site</button><div class="c-viewexternal__text">Item not freely available? 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Health Resources and Services Administration (HRSA)-funded health centers (HCs) provide comprehensive primary care in rural communities. However, no prior research has examined trends in access to care in rural HC patients. We examined the change in access to care among patients served at rural HRSA-funded HCs in the United States between 2009 and 2014.<h4>Methods</h4>We compared patients by year to examine measures of access using multilevel generalized structural equation logistic regression models with random effects. We used the 2009 and 2014 cross-sectional Health Center Patient Surveys and identified 2,625 adult rural HC patients. Dependent variables were subjective (unmet need/delay in medical care, mental health, dental care, and prescription medications) and objective measures (preventive care and other health care utilization) in access to care. 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