News: U.S. has highest rural healthcare disparities out of 11 developed countries, report says

The United States has the highest healthcare disparities between urban and rural residents, according to a recent study published in the Journal of the American Medical Association (JAMA) Network Open.

The report surveyed 22,402 individuals across 11 different developed countries, using 10 different health indicators—health status and socioeconomic risk factors, affordability of care, and access of care, etc.—to determine the extent of the disparities.

Most notably, the report concluded that the U.S. had the most significant healthcare disparities in five out of the 10 indicators.

Here as some highlights from the report:

• Germany had the lowest percentage of chronic conditions (15%), mental health conditions (10.3%), and reported material hardships (6.1%); by contrast, the U.S. had the highest percentage of chronic conditions (28.4%), mental health conditions (29.0%), and reported material hardships (16.3%).
• The U.S. has the highest percentage of patients who skipped needed medical appointments (39%) due to issues of affordability; by contrast, Sweden (8.2%) and Norway (21.4%) had the lowest percentages.
• Canada, Sweden, and the U.S. reported the greatest rural disparities in healthcare, with the lowest percentages of regular clinicians and places of care (92.9%, 90%, 92.1%), highest percentages in reporting a difficulty accessing after-hours care (64.7%, 75.3%, 60%), and the highest percentages for having avoidable emergency department visits in the past two years (38.4%, 31.2%, 51.9%).
• The country with the best access to medical care was the Netherlands, with 83 of 753 respondents (97.7%) having a regular clinician or place of care, and 50 (71.0%) obtaining same day care the last time needed. Only 16 (30.7%) had difficulty accessing afterhours care and five (38.0%) had an avoidable emergency department (ED) visit in the past two years.

According to the lead author of the study, Professor Neil MacKinnon of the Medical College of Georgia, the primary cause of these disparities is rooted in the type of payer system found in each country:

"If you have a single-payer system, there's more consistency across geography," he said. "In the U.S., because its system is so different from that of the other countries, there are bigger differences [between rural and urban healthcare] because of payer mix and so forth."

Editor’s note: To read the JAMA report, click here. To read the MedScape article, click here.