Chartbook on Rural Health Care

Disparities in measures of quality between large fringe metropolitan and micropolitan and noncore areas, 2011-2012

Key: n = number of measures.

• Better = Population received better quality of care than reference group.
• Same = Population and reference group received about the same quality of care.
• Worse = Population received worse quality of care than reference group.

Note: For each measure, the most recent data year available was analyzed. These data represent 2011-2012.

• Residents living in micropolitan areas received:
  • Better quality of care for 4% (6 out of 138) of the measures, compared with those living in large fringe metropolitan areas.
  • Worse quality of care for 25% (35 out of 138) of the measures, compared with those living in large fringe metropolitan areas.
  • The same quality of care for 71% (97 out of 138) of the measures, compared with those living in large fringe metropolitan areas.
• Residents who live in noncore areas received:
  • Better quality of care for 6% (8 out of 139) of the measures, compared with those living in large fringe metropolitan areas.
  • Worse quality of care for 31% (43 out of 139) of the measures, compared with those living in large fringe metropolitan areas.
  • The same quality of care for 63% (88 out of 139) of the measures, compared with those living in large fringe metropolitan areas.

Disparities in Quality of Care for Micropolitan Areas

Disparities in quality of care measures for micropolitan areas by 4 NQS priorities and Access

Key: n = number of measures.

•  Better = Population received better quality of care than reference group.
•  Same = Population and reference group received about the same quality of care.
•  Worse = Population received worse quality of care than reference group.

• Overall: Residents of micropolitan areas are doing worse than residents of large fringe metropolitan areas on Effective Treatment, Healthy Living, and Access measures compared with Person-Centered Care measures.
• Patient Safety: Residents of micropolitan areas received better care for 21%, same care for 58%, and worse care for 21% of the measures compared with residents of large fringe metropolitan areas.
• Person-Centered Care: Residents of micropolitan areas received the same care for 100% of the measures as residents of large fringe metropolitan areas.
• Effective Treatment: Residents of micropolitan areas received the same care for 70% and worse care for 30% of the measures compared with residents of large fringe metropolitan areas.
• Healthy Living: Residents of micropolitan areas received better care for 4%, the same care for 56%, and worse care for 40% of the measures compared with residents of large fringe metropolitan areas.
• Access: Residents of micropolitan areas received the same care for 58% and worse care for 42% of the measures compared with residents of large fringe metropolitan areas.
• There are insufficient numbers of reliable measures of Care Coordination and Care Affordability to summarize in this way.

Disparities in Quality of Care for Noncore Areas

Disparities in quality of care measures for noncore areas by 4 NQS priorities and Access

Key: n = number of measures.

• Better = Population received better quality of care than reference group.
• Same = Population and reference group received about the same quality of care.
• Worse = Population received worse quality of care than reference group.

• Overall: Residents of noncore areas are doing worse than residents of large fringe metropolitan areas on Effective Treatment, Healthy Living, and Access measures compared with Person-Centered Care measures.
• Patient Safety: Residents of noncore areas received better care for 11%, the same care for 68%, and worse care for 21% of the measures compared with residents of large fringe metropolitan areas.
• Person-Centered Care: Residents of noncore areas received the same care for 88% and worse care for 12% of the measures compared with residents of large fringe metropolitan areas.
• Effective Treatment: Residents of noncore areas received better care for 4%, the same care for 57%, and worse care for 39% of the measures compared with residents of large fringe metropolitan areas.
• Healthy Living: Residents of noncore areas received better care for 3%, the same care for 56%, and worse care for 41% of the measures compared with residents of large fringe metropolitan areas.
• Access: Residents of noncore areas received the same care for 64% and worse care for 36% of the measures compared with residents of large fringe metropolitan areas.
• There are insufficient numbers of reliable measures of Care Coordination and Care Affordability to summarize in this way.

Change in Disparities Between Large Fringe Metropolitan and Nonmetropolitan Areas

Change in disparities in measures of quality between large fringe metropolitan and micropolitan and noncore areas, 2011-2012

Key: n = number of measures.

• Improving = Disparity is getting smaller at a rate greater than 1% per year.
• No change = Disparity is not changing or is changing at a rate less than 1% per year.
• Worsening = Disparity is getting larger at a rate greater than 1% per year.

Note: For each measure, the earliest and most recent data year available were analyzed through 2011-2012

• For residents of micropolitan areas:
  • Disparities were getting smaller for 8% (9 out of 116) of the measures, compared with residents of large fringe metropolitan areas.
  • Disparities were getting larger for 6% (7 out of 116) of the measures, compared with residents of large fringe metropolitan areas.
  • Disparities did not change for 86% (100 out of 116) of the measures, compared with residents of large fringe metropolitan areas.
• For residents of noncore areas:
  • Disparities were getting smaller for 5% (6 out of 117) of the measures, compared with residents of large fringe metropolitan areas.
  • Disparities were getting larger for 9% (10 out of 117) of the measures, compared with residents of large fringe metropolitan areas.
  • Disparities did not change for 86% (101 out of 117) of the measures, compared with residents of large fringe metropolitan areas.

Change in Disparities for Micropolitan Areas

Change in disparities for micropolitan areas by 4 NQS priorities and Access

Key: n = number of measures.

• Improving = Disparity is getting smaller at a rate greater than 1% per year.
• No change = Disparity is not changing or is changing at a rate less than 1% per year.
• Worsening = Disparity is getting larger at a rate greater than 1% per year.

• Overall: There is no clear pattern in the reduction of disparities between people living in micropolitan areas and people living in large fringe metropolitan areas.
• Patient Safety: Disparities got larger for 5% of the measures and there was no change in 95% of the measures.
• Person-Centered Care: There was no change in disparities for 100% of the measures.
• Effective Treatment: Disparities got smaller for 7% of the measures, there was no change in 90%, and disparities got larger for 3% of the measures.
• Healthy Living: Disparities got smaller for 5% of the measures, there was no change in 90%, and disparities got larger for 5% of the measures.
• Access: Disparities got smaller for 9% of the measures, there was no change in 86%, and disparities got larger for 5% of the measures.
• There are insufficient numbers of reliable measures of Care Coordination and Care Affordability to summarize in this way.

Change in Disparities for Noncore Areas

Change in disparities for noncore areas by 4 NQS priorities and Access

Key: n = number of measures.

• Improving = Disparity is getting smaller at a rate greater than 1% per year.
• No change = Disparity is not changing or is changing at a rate less than 1% per year.
• Worsening = Disparity is getting larger at a rate greater than 1% per year.

• Overall: There is no clear pattern in the reduction of disparities between people living in noncore areas and people living in large fringe metropolitan areas.
• Patient Safety: Disparities got larger for 5% and did not change for 95% of the measures.
• Person-Centered Care: There was no change in disparities in 100% of the measures.
• Effective Treatment: Disparities got smaller for 9% of the measures, there was no change in 82%, and disparities got larger for 9% of the measures.
• Healthy Living: Disparities got larger for 10% and did not change for 90% of the measures.
• Access: Disparities got larger for 4% and did not change for 96% of the measures.
• There are insufficient numbers of reliable measures of Care Coordination and Care Affordability to summarize in this way.

Trends in Measures of Quality for Nonmetropolitan Areas

Trends in measures of quality for micropolitan and noncore areas

Key: n = number of measures.

• Improving = Quality is going in a positive direction at an average annual rate greater than 1% per year.
• No change = Quality is not changing or is changing at an average annual rate less than 1% per year.
• Worsening = Quality is going in a negative direction at an average annual rate greater than 1% per year.

Note: For each measure, the earliest and most recent data year available were analyzed through 2011 to 2012.

• The quality of care for residents living in micropolitan areas:
  • Improved for 46% (55 out of 119) of the measures.
  • Worsened for 10% (12 out of 119) of the measures.
  • Did not for 44% (52 out of 119) of the measures.
• The quality of care for residents living in noncore areas:
  • Improved for 48% (62 out of 131) of the measures.
  • Worsened for care for 8% (11 out of 131) of the measures.
  • Did not change for 44% (58 out of 131) of the measures.

Trends in Measures of Quality for Micropolitan Areas

Trends in measures of quality for micropolitan areas by 4 NQS priorities and Access

Key: M = median.

• Each point represents one measure. The large red diamonds indicate median values. Quality of health care has improved steadily but the median pace of change varies across National Quality Strategy (NQS) priorities and Access.
• Median change in quality for residents of micropolitan areas was:
  • 1.13% per year among measures of Healthy Living.
  • 2.24 per year among measures of Effective Treatment.
  • 2.08% per year among measures of Patient Safety.
  • 2.31% per year among measures of Person-Centered Care.
  • 0.22% per year among measures of Access.
• There are insufficient numbers of reliable measures of Care Coordination and Care Affordability to summarize in this way.

Trends in Measures of Quality for Noncore Areas

Trend in measures of quality for noncore areas by 4 NQS priorities and Access

Key: M = median.

• Each point represents one measure. The large red diamonds indicate median values. Quality of health care has improved steadily but the median pace of change varies across National Quality Strategy (NQS) priorities and Access.
• Median change in quality for residents on noncore areas was:
  • 1.38% per year among measures of Healthy Living.
  • 1.97 per year among measures of Effective Treatment.
  • 2.31% per year among measures of Patient Safety.
  • 2.92% per year among measures of Person-Centered Care.
  • 0.57% per year among measures of Access.
• There are insufficient numbers of reliable measures of Care Coordination and Care Affordability to summarize in this way.

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