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	Contribution of Social Determinant of Health Factors to Rural-Urban Preventive Care Differences Among Medicaid Enrollees
	Hardy, Rose Y.; Liu, Gilbert C.; Kelleher, Kelly
通讯作者	Hardy, RY (corresponding author), Nationwide Childrens Hosp, Ctr Innovat Pediat Practice, Abigail Wexner Res Inst, 700 Childrens Dr, Columbus, OH 43215 USA.
来源期刊	ACADEMIC PEDIATRICS
ISSN	1876-2859
EISSN	1876-2867
出版年	2021
卷号	21 期号:1 页码:93-100
英文摘要	OBJECTIVE: 1) Assess whether rural-urban disparities are present in pediatric preventive health care utilization; and 2) use regression decomposition to measure the contribution of social determinants of health (SDH) to those disparities. METHODS: With an Ohio Medicaid population served by a pediatric Accountable Care Organization, Partners For Kids, between 2017 and 2019, we used regression decomposition (a nonlinear multivariate regression decomposition model) to analyze the contribution of patient, provider, and SDH factors to the rural-urban well-child visit gap among children in Ohio. RESULTS: Among the 453,519 eligible Medicaid enrollees, 61.2% of urban children received a well-child visit. Well-child visit receipt among children from large rural cities/towns and small/isolated towns was 58.2% and 55.5%, respectively. Comparing large rural towns to urban centers, 55.8% of the 3.0 percentage-point difference was explained by patient, provider, and community-level SDH factors. In comparing small/isolated town to urban centers, 89.8% of the 5.7 percentage-point difference was explained by these characteristics. Of provider characteristics, pediatrician providers were associated with increased well visit receipt. Of the SDH factors, unemployment and education contributed the most to the explained difference in large rural towns while unemployment, education, and food deserts contributed significantly to the small/isolated town difference. CONCLUSIONS: The receipt of pediatric preventive care is slightly lower in rural communities. While modest, the largest part of the rural-urban preventive care gap can be explained by differences in provider type, poverty, unemployment, and education levels. More could be done to improve pediatric preventive care in all communities.
英文关键词	rural health care social determinants of health well-child care
类型	Article
语种	英语
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000607291700014
WOS关键词	NEIGHBORHOOD ; DISPARITIES ; PATTERNS ; CHILDREN ; VISITS
WOS类目	Pediatrics
WOS研究方向	Pediatrics
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/347608
作者单位	[Hardy, Rose Y.; Kelleher, Kelly] Nationwide Childrens Hosp, Ctr Innovat Pediat Practice, Abigail Wexner Res Inst, 700 Childrens Dr, Columbus, OH 43215 USA; [Liu, Gilbert C.] Nationwide Childrens Hosp, Partners Kids, Columbus, OH 43215 USA; [Kelleher, Kelly] Nationwide Childrens Hosp, Dept Pediat, Columbus, OH 43215 USA
推荐引用方式 GB/T 7714	Hardy, Rose Y.,Liu, Gilbert C.,Kelleher, Kelly. Contribution of Social Determinant of Health Factors to Rural-Urban Preventive Care Differences Among Medicaid Enrollees[J],2021,21(1):93-100.
APA	Hardy, Rose Y.,Liu, Gilbert C.,&Kelleher, Kelly.(2021).Contribution of Social Determinant of Health Factors to Rural-Urban Preventive Care Differences Among Medicaid Enrollees.ACADEMIC PEDIATRICS,21(1),93-100.
MLA	Hardy, Rose Y.,et al."Contribution of Social Determinant of Health Factors to Rural-Urban Preventive Care Differences Among Medicaid Enrollees".ACADEMIC PEDIATRICS 21.1(2021):93-100.