Rural-Urban Differences in Health Care Unaffordability During the Postpartum Period
Bibliographic Data
| ID | 9105094 |
|---|---|
| Authors | Hannah MacDougall (0000-0001-7124-3913, University of Minnesota School of Social Work, Saint Paul, corresponding author), Stephanie Hanson (0000-0003-2452-1540, University of Minnesota School of Social Work, Saint Paul, corresponding author), Julia D Interrante (0000-0001-8579-6623, University of Minnesota School of Public Health, Minneapolis, MN), Erica Eliason (Brown University School of Public Health, Providence, Rhode Island), Erica L Eliason (0000-0002-5246-3176, Brown University) |
| Year | 2023 |
| Volume | 61 |
| Issue | 9 |
| Pages | 595-600 |
| Publication date | 2023-09-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001888 |
| PMID | 37561603 |
| OpenAlex | W4385737437 |
| Language | EN |
| References cited | 9 |
OBJECTIVE: The objective of this study was to examine health care unaffordability for rural and urban residents and by postpartum status. METHODS: We used cross-sectional survey data on female-identifying respondents ages 18-44 (n=17,800) from the 2019 to 2021 National Health Interview Study. Outcomes of interest were 3 measures of health care unaffordability. We conducted bivariate and multivariable regression models to assess the association between health care unaffordability, rurality, and postpartum status. RESULTS: Bivariate analyses showed postpartum people reported statistically significantly higher rates of being unable to pay medical bills and having problems medical paying bills, as compared with nonpostpartum people. Rural residents also reported statistically significantly higher rates of being unable to pay their medical bills and having problems paying medical bills as compared with urban residents. In adjusted models, the predicted probability of being unable to pay medical bills among postpartum respondents was 12.8% (CI, 10.1-15.5), which was statistically significantly higher than among nonpostpartum respondents. Similarly, postpartum respondents had statistically significantly higher predicted probabilities of reporting problems paying medical bills (18.4%, CI, 15.4-21.4) as compared with nonpostpartum respondents. The rural residency was not significantly associated with the health care unaffordability outcome measures in adjusted models. CONCLUSIONS: Both postpartum and rural respondents reported higher rates of being unable to pay medical bills and having problems paying medical bills; however, after adjusting for covariates, only postpartum respondents reported statistically significantly higher rates of these outcomes. These results suggest that postpartum status may present challenges to health care affordability that span the urban/rural context
Environmental health · Period (music) · Postpartum period · Pregnancy · Rural area · Global Maternal and Child Health · Healthcare Policy and Management · Maternal and Perinatal Health Interventions · Medicine
| Citation velocity | historical |
|---|---|
| Highly cited | No |