Access to healthcare more difficult for rural Americans

WASHINGTON Wed Jul 27, 2011 2:55pm EDT

Duane Michelson, 90, and his daughter Darla Shultz, 49, watch television at Shultz's home in Independence, Iowa, July 6, 2011. Shultz has recently taken on the responsibility of taking care of her father as his health has started to decline in an effort to keep him at home and out of a nursing home. REUTERS/Jessica Rinaldi

Duane Michelson, 90, and his daughter Darla Shultz, 49, watch television at Shultz's home in Independence, Iowa, July 6, 2011. Shultz has recently taken on the responsibility of taking care of her father as his health has started to decline in an effort to keep him at home and out of a nursing home.

Credit: Reuters/Jessica Rinaldi

WASHINGTON (Reuters Life!) - Rural Americans are more likely to suffer from chronic health conditions such as diabetes, heart problems and cancer, and face greater difficulty getting quality healthcare than their urban counterparts, according to a report released Wednesday.

The challenges facing healthcare providers for rural areas could be compounded by recent healthcare legislation, according to the UnitedHealth Center for Health & Reform Modernization.

"This is kind of an opportunity," UnitedHealth chair and report author Simon Stevens told Reuters. "Expanding coverage will mean that more people will have the ability to access care than before, but it's also a wake-up call."

The Center projects that around 8 million more rural residents will join Medicaid, state and government-subsidized insurance plans in the national coverage expansions than would have otherwise -- a net expansion of some 5 million people.

The paper found that there are only 65 primary care physicians per 100,000 rural Americans -- 40 or so less than the 105 per 100,000 urban and suburban Americans.

Already five million rural residents live in "shortage areas" defined by the federal government as counties with less than 33 primary care physicians per 100,000 residents. The number is continuing to decrease.

Per capita in rural areas there is less than half the number of surgeons and other specialists.

A survey that was part of the study found that among roughly 3,000 patients and primary physicians queried nationwide, those from rural areas were more likely to respond that drug abuse and teen pregnancy are major concerns than were those from urban areas.

Those from rural areas also generally thought the quality of care was lower in their communities than in urban ones.

UnitedHealth confirmed this "equality deficit" is supported by data showing that in 70 percent of markets, rural quality of care was measurably worse than in urban areas.

Though the rural population is aging, placing pressure on public programs like Medicare and Medicaid, UnitedHealth projects rural areas could see higher growth in their non-elderly insured population than urban areas, with increases of over 20 percent in the South and West.

RURAL RESPONSE TO GROWTH

Rural primary care physicians are 15 percent more likely to accept new Medicaid patients as of 2014 than their urban counterparts. Already, urban doctors receive a greater share of their income from public programs than urban doctors.

The report's "roadmap toward a 21st-century health care system," includes a bigger role for nurse practitioners, mobile health clinics, faster uptake of electronic record technology, designing insurance market and public program regulation to meet the needs of rural areas, and engaging more rural consumers in improving their health.

Telemedicine technologies, which use tools such as broadband connectivity to facilitate communication between patients and providers, are crucial to rural areas where distance and low patient and provider density contribute to these health care challenges, according to the report.

UnitedHealth calls for a coordinated effort by patients, providers, private and public sectors to ensure that coverage expansions do not make existing problems worse.

"The next few years will be times of considerable stress on rural health care," the conclusions state, "but also times of great opportunity."

(Editing by Jerry Norton)

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