Arthritis health service utilization among the elderly: The role of urban‐rural residence and other utilization factors

Saag, Kenneth G.; Doebbeling, Bradley N.; Rohrer, James E.; Kolluri, Sheela; Mitchell, Theresa A.; Wallace, Robert B.

doi:10.1002/art.1790110305

Cited by 25 publications

(18 citation statements)

References 14 publications

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“…This disparity may reflect racial differences in risk factors, access to health care, insurance coverage, level of socioeconomic resources, and medical care seeking behaviors and is consistent with general use of ambulatory medical services (13). Urban versus rural visit rate differences are consistent with patterns of rural health care utilization in other studies (21). Ambulatory care visits for arthritis and other rheumatic conditions occurred in various settings, including the emergency department, and included contact with a wide variety of providers, such as physicians, nursing staff, and midlevel practitioners.…”

supporting

confidence: 82%

Magnitude and characteristics of arthritis and other rheumatic conditions on ambulatory medical care visits, United States, 1997

Hootman¹,

Helmick²,

Schappert³

2002

Arthritis & Rheumatism

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Objective. To describe ambulatory medical care utilization, defined to exclude injury-related visits, for persons with arthritis and other rheumatic conditions. Methods. National estimates, rates, and other characteristics of ambulatory care visits were calculated from a national sample of patient visits to physician offices and acute care hospital outpatient and emergency departments.Results. An estimated 36.5 million ambulatory care visits were related to arthritis and other rheumatic conditions. Visit rates increased with age and, overall, were twice as high among women as men. Rates of visits by race varied by ambulatory care setting. Soft tissue disorders (9.3 million), osteoarthritis (7.1 million), nonspecific joint pain/effusion (7.0 million), and rheumatoid arthritis (3.9 million) were the most common diagnoses. Conclusions. Arthritis and other rheumatic conditions account for about as many ambulatory care visits as cardiovascular disease or essential hypertension. These visits serve as excellent opportunities to counsel patients regarding prevention messages for arthritis.

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supporting

confidence: 82%

Magnitude and characteristics of arthritis and other rheumatic conditions on ambulatory medical care visits, United States, 1997

Hootman¹,

Helmick²,

Schappert³

2002

Arthritis & Rheumatism

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“…Few studies have examined the effects of insurance status on access to appropriate care for rheumatology patients (10,(12)(13)(14), and, to our knowledge, no studies have examined access to care for patients with SLE. In our study, we calculated the distance to primary lupus providers in a large established cohort of patients with SLE and examined the association of Medicaid insurance with distance traveled to care.…”

Section: Introductionmentioning

confidence: 99%

Medicaid and access to care among persons with systemic lupus erythematosus

Gillis¹,

Yazdany²,

Trupin³

et al. 2007

Arthritis & Rheumatism

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Objective. To evaluate the associations between Medicaid insurance and distance traveled by patients to treating physicians and health care utilization for patients with systemic lupus erythematosus (SLE). Methods. A total of 982 adults with SLE were recruited between 2002 and 2004. We calculated the distance between patient homes and physicians using Mapquest, an Internet mapping program. We then assessed the association between Medicaid status and distance traveled to the primary SLE provider, presence of >1 physician visits, and the number of all physician visits, with and without adjustment for demographic and medical covariates. Results. On an unadjusted basis, Medicaid patients traveled longer distances to see their primary SLE provider. This effect was pronounced for patients under the care of a rheumatologist. Adjustment reduced, but did not eliminate, these differences. With adjustment for covariates, Medicaid patients were equally as likely to see a rheumatologist as non-Medicaid patients. However, Medicaid patients were more likely to be seen by a general practitioner or in the emergency room for their SLE, and reported more visits to general practitioners and the emergency room for SLE. Conclusion. Medicaid patients with SLE traveled longer distances to see an SLE physician, especially rheumatologists. They also reported a different pattern of health care utilization. These results suggest that Medicaid patients may face barriers in obtaining comprehensive medical services in proximity to their residences.

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“…In general, rural residents are predominately less educated, have lower incomes, and are more likely to be elderly, with the exception of the Aboriginal population (Nemet & Bailey, 2000;Saag, Doebbeling, et al, 1998;Wood, Sallar, Schechter & Hogg, 2000). Despite these characteristics, it is difficult to determine if the differences between health status for the two populations is a real difference or an assumed difference related to the identified determinants.…”

Section: Health Status In Aboriginal and Rural Populationsmentioning

confidence: 99%

“…Rural residents tend to utilize health services less frequently than their urban counterparts and for the most part, tend to use less costly services (Overland, Yue, Mira, 2001;Saag, Doebbeling, et al, 1998;Thiede-Call, Casey, and Radcliff, 2000). The literature also indicates that access, particularly as it relates to distance and travel, is far less of an issue than the actual availability of health services and providers (Dansky & Dirani, 1998;Dellasega & Fisher, 2001;Rost, Fortney, Fischer et al, 2002).…”

mentioning

confidence: 99%

“…This is especially true with regards to both personal assistance and home care in rural and Aboriginal communities where taking care of one's family is considered a cultural norm. The sense of obligation to family can be considered a strength as it speaks to the notion that rural residents are believed to be more resilient and self-sustaining than their more urban counterparts (Nemet & Bailey, 2000;Saag et al 1998;Yesalis et al, 1985).…”

mentioning

confidence: 99%

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Comparison of health service utilization between Aboriginal and non-Aboriginal people living in the Bella Coola Valley.

Tatlock¹

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Arthritis health service utilization among the elderly: The role of urban‐rural residence and other utilization factors

Abstract: Objective. To compare the impact of urban-rural residence and other factors on the utilization of any type of arthritis-related physician care and on rheumatologist utilization.Methods. A population-based random sample of adults 65

Cited by 25 publications

References 14 publications

Magnitude and characteristics of arthritis and other rheumatic conditions on ambulatory medical care visits, United States, 1997

Magnitude and characteristics of arthritis and other rheumatic conditions on ambulatory medical care visits, United States, 1997

Medicaid and access to care among persons with systemic lupus erythematosus

Comparison of health service utilization between Aboriginal and non-Aboriginal people living in the Bella Coola Valley.

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