The Effects of Rurality on Health Outcomes for Children with Special Health Care Needs
Ellsworth, Charles G.
This paper considers the effect of rurality on health outcomes and key health indicators for children with special health care needs (CSHCN), who utilize health services in greater frequency and intensity than children generally. My thesis is that CSHCN living in rural areas are associated with poorer individual health care indicators and outcome measurements than their urban counterparts, including the critical needs of receiving adequate care coordination and receiving care through a "medical home." To test this hypothesis, I completed a multivariate analysis of 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), conducted by the National Center for Health Statistics, accounting for rurality as well as controlling for income, education, race, ethnicity, insurance coverage and health status. I conducted 21 separate regressions using logit and ordered logit analyses, with odds-ratio output. The regression analysis does not support my hypothesis, and shows that for almost all instances, CSHCN living in rural areas are not less likely to achieve the key health outcomes and are not less likely to be associated with negative health indicators than their urban counterparts. I recommend that better publicly-available data are needed to isolate the true effect of rurality in this population and that further research should be conducted.
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