Chartbook on Rural Health Care

Specific Source of Ongoing Care

People with a specific source of ongoing care, by residence location, 2009-2012

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2009-2012.

• Importance: People with a usual source of care have better health outcomes and fewer disparities and costs (Healthy People 2020). Having a usual place of care and a usual provider are associated with an increased likelihood of receiving preventive services and recommended screenings compared with having no usual source of care (Blewett, et al., 2008).
• Overall Rate: In 2012, the percentage of people with a specific source of ongoing care was 85.9%.
• Change Over Time: From 2009 to 2012, the percentage of people with a specific source of ongoing care improved for residents of small metropolitan areas.
• Groups With Disparities:
  • In 2012, the percentage of people with a specific source of ongoing care was lower for residents of large central metropolitan, medium metropolitan, and small metropolitan areas compared with residents of large fringe metropolitan areas.
  • In all years, the percentage of people with a specific source of ongoing care was lower for residents of large central metropolitan, medium metropolitan, and small metropolitan areas compared with residents of large fringe metropolitan areas.

Hospital, Emergency Room, or Clinic as a Source of Ongoing Care

People who identified a hospital, emergency room, or clinic as a source of ongoing care, by residence location, stratified by race/ethnicity, 2012

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
Note: For this measure, lower rates are better. White and Black are non-Hispanic. Hispanic includes all races.

• Overall Rate: In 2012, the percentage of people who identified a hospital, emergency room, or clinic as a source of ongoing care was higher for residents of large central metropolitan, medium metropolitan, small metropolitan, micropolitan, and noncore areas compared with residents of large fringe metropolitan areas.
• Groups With Disparities:
  • In 2012, the percentage of people who identified a hospital, emergency room, or clinic as a source of ongoing care was higher for residents of large central metropolitan, medium metropolitan, small metropolitan, micropolitan, and noncore areas compared with residents of large fringe metropolitan areas among non-Hispanic Whites and non-Hispanic Blacks.
  • In 2012, the percentage of people who identified a hospital, emergency room, or clinic as a source of ongoing care was higher for residents of large central metropolitan, medium metropolitan, micropolitan, and noncore areas compared with residents of large fringe metropolitan areas among Hispanics.
  • In 2012, more than half of Hispanics living in noncore areas identified a hospital, emergency room, or clinic as a source of ongoing care.

Emergency Department Visits With a Principal Diagnosis Related to Dental Conditions

Emergency department visits with a principal diagnosis related to dental conditions per 100,000 population, by residence location, 2010-2012

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, National Emergency Department Sample, 2010-2012.
Denominator: U.S. resident population.
Note: For this measure, lower rates are better.

• Importance: Patients with limited access to community dental providers may seek dental care in emergency departments.
• Overall Rate: In 2012, the rate of emergency department visits for dental conditions was 447 per 100,000 population among residents of micropolitan and noncore areas.
• Groups With Disparities: In all years, use of emergency departments for dental conditions was higher among residents of micropolitan and noncore areas and of medium and small metropolitan areas than among residents of large fringe metropolitan areas (suburbs).

Trauma Center Utilization

Trauma center utilization for severe injuries, by residence location, 2012

Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, National Emergency Department Sample, 2012.
Denominator: Patients with an emergency department visit for severe injuries.
Note: Injuries with an Injury Severity Score of 16 or greater were considered severe.

• Importance: Most patients with severe injuries are treated in Level I or II trauma centers, but access to trauma centers may be more difficult for residents of rural areas.
• Overall Rate: In 2012, 63% of all patients with severe injuries were treated in Level I or II trauma centers (data not shown).
• Groups With Disparities: Residents of micropolitan and noncore areas with severe injuries were less likely to be treated in Level I or II trauma centers and more likely to be treated in nontrauma emergency departments compared with residents of large fringe metropolitan areas (suburbs), but some of these difference were not statistically significant due to small sample sizes.

Usual Source of Care With Office Hours at Night or on Weekends

People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends, by residence location, 2005-2012

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2005-2012.

• Overall Rate: In 2012, 42.5% of people had a usual source of care, excluding hospital emergency rooms, with office hours at night or on weekends.
• Change Over Time: From 2005 to 2012, the percentage of people with a usual source of care, excluding hospital emergency rooms, who had office hours at night or on weekends, improved for people living in micropolitan areas and worsened for those living in small metropolitan areas.
• Groups With Disparities:
  • In 2012, the percentage of people with a usual source of care, excluding hospital emergency rooms, who had office hours at night or on weekends was lower for people living in large central metropolitan, medium metropolitan, small metropolitan, micropolitan, and noncore areas compared with those living in large fringe metropolitan areas.
  • In all years, the percentage of people with a usual source of care, excluding hospital emergency rooms, who had office hours at night or on weekends was lower for people living in medium metropolitan, micropolitan, and noncore areas compared with those living in large fringe metropolitan areas.
  • In 7 of 8 years, the percentage of people with a usual source of care, excluding hospital emergency rooms, who had office hours at night or on weekends was lower for people living in small metropolitan areas compared with those living in large fringe metropolitan areas.
  • In 5 of 8 years, the percentage of people with a usual source of care, excluding hospital emergency rooms, who had office hours at night or one weekends was lower for people living in large central metropolitan areas compared with those living in large fringe metropolitan areas.

Usual Source of Care With Office Hours at Night or on Weekends

People with a usual source of care, excluding hospital emergency rooms, who has office hours at night or on weekends, by residence location, stratified by income, 2012

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2012.

• Overall Rate: In 2012, the percentage of people with a usual source of care, excluding hospital emergency rooms, who had office hours at night or on weekends was lower for residents of large central metropolitan, medium metropolitan, small metropolitan, micropolitan, and noncore areas compared with residents of large fringe metropolitan areas.
• Groups With Disparities:
  • In 2012, among people with middle and high income, the percentage of people with a usual source of care, excluding hospital emergency rooms, who had office hours at night or on weekends was lower for residents of medium metropolitan, small metropolitan, micropolitan, and noncore areas compared with residents of large fringe metropolitan areas.
  • In 2012, among people with low income, the percentage of people with a usual source of care, excluding hospital emergency rooms, who had office hours at night or on weekends was lower for residents of large central metropolitan, small metropolitan, micropolitan, and noncore areas compared with residents of large fringe metropolitan areas.
  • In 2012, among poor people, the percentage of people with a usual source of care, excluding hospital emergency rooms, who had office hours at night or on weekends was lower for residents of large central metropolitan, micropolitan, and noncore areas compared with residents of large fringe metropolitan areas.

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