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Rural Health

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Rural youths are much more likely to receive preventive and acute care if they have a regular source of care

Rural adolescents with no regular source of care are much less likely to obtain preventive or illness care than adolescents with a regular source of care. Those with a regular provider also are less likely to seek emergency care, according to a study supported by the Agency for Healthcare Research and Quality (HS07045).

Researchers from the University of Rochester School of Medicine and the Johns Hopkins School of Hygiene and Public Health surveyed students at two middle schools and two high schools in rural areas of one State about their health status and use of health care services to identify factors predicting use of these services. One-third of the youths said they had received preventive care services within the prior 3 months, 41 percent received problem-focused care, and 18 percent received emergency care.

Adolescents who had a regular provider for care when they were sick but not for preventive care were much less likely to have received preventive care within the prior 3 months than those with the same source of care for both preventive and illness care. Similarly, adolescents with a regular source of care for preventive but not illness care were half as likely to have received illness care as young people who had the same source of care for both preventive and illness care. Finally, the fragmentation in care that occurs when adolescents have different sources of preventive and illness care almost doubled the likelihood that the young people had used emergency services.

Clearly, having a regular source of both preventive and illness care is important in ensuring receipt of preventive services and timely illness care and in limiting inappropriate emergency room use. Few sociodemographic factors were significantly associated with use of health care services. However, medical need did influence use of care. Adolescents who had more functional limitations, a greater number of diagnosed conditions, and higher scores on an individual risk behavior scale were more likely to have received illness or problem-focused care. For example, adolescents with four to six medical diagnoses were twice as likely to have received illness care as those with fewer than two diagnoses.

See "The effects of regular source of care and health need on medical care use among rural adolescents," by Sheryl Ryan, M.D., Anne Riley, R.N., Ph.D., Myungsa Kang, M.S., and Barbara Starfield, M.D., M.P.H., in the February 2001 Archives of Pediatric and Adolescent Medicine 155, pp. 184-190.

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