Sarah MacCarthy|Marc N. Elliott|Steven C. Martino|David J. Klein|Amelia Haviland|Robert Weech?Maldonado|Jacob W. Dembosky|Loida Tamayo|Sarah Gaillot|Eric C. Schneider
Rural disparities in the quality of clinical care are notable and larger for males
University of Alabama at Birmingham|RAND Corporation|RAND Corporation|RAND Corporation|RAND Corporation|Carnegie Mellon University|University of Alabama at Birmingham|RAND Corporation|Centers for Medicare and Medicaid Services|Centers for Medicare and Medicaid Services|National Committee for Quality Assurance
abstract purpose investigate whether ruralurban differences quality care medicare advantage enrollees vary females males methods data study came 2019 healthcare effectiveness data information set linear regression used investigate urbanrural differences individual enrollee scores 34 clinical care measures grouped 7 categories differences varied sex evaluation statistical interactions findings across 7 categories measures scores rural residents worse scores urban residents 4 categoriescare patients suspected chronic obstructive pulmonary disease avoiding prescription misuse behavioral health diabetes carethe average difference across measures category greater 3 percentage points across 34 measures 15 statistically significant ruralbysex interactions exceeded 1 percentage point 11 cases deficit associated living rural area greater males females 3 cases deficit associated living rural area larger females males 1 case involving followup hospitalization mental illness rural residents advantage larger males females conclusions interventions may help address patient eg health literacy patient activation provider eg workforce recruitment retention structurallevel issues contributing disparities especially rural males