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Related Experiment Videos

Rural and urban physicians: does the content of their Medicare practices differ?

L M Baldwin, R A Rosenblatt, R Schneeweiss

    The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
    |October 8, 1999
    PubMed
    Summary

    Rural physicians see more elderly patients and have higher outpatient volumes. However, most specialties show similar diagnostic scope, except for rural general surgeons and obstetrician-gynecologists who manage conditions outside their core training.

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    Area of Science:

    • Medical Practice Analysis
    • Rural Health Disparities
    • Physician Practice Patterns

    Background:

    • Significant disparities exist between rural and urban areas regarding medical technology, practice structures, and patient demographics.
    • Understanding these differences is crucial for equitable healthcare delivery and physician training.

    Purpose of the Study:

    • To investigate if rural-urban differences in practice content exist among physicians.
    • To compare practice scope, patient populations, and procedure types between rural and urban physicians.

    Main Methods:

    • Analysis of 1994 Medicare claims data for board-certified physicians in 12 ambulatory specialties.
    • Comparison of patient volume, visit types, diagnostic scope, and procedure frequency between rural and urban practitioners.

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  • Stratification by specialty, diagnosis, patient age, and sex.

    • Main Results:

    • Rural physicians were older, less likely to be female, saw more elderly patients, and had higher outpatient visit volumes.
    • Diagnostic scope was largely similar across specialties, with exceptions in general surgery (gastrointestinal) and obstetrics-gynecology (hypertension, diabetes).
    • Procedural scope showed more similarities than differences between rural and urban physicians.

    Conclusions:

    • While most rural and urban physicians require similar training for elderly care, rural general surgeons and obstetrician-gynecologists need additional training in non-traditional areas.
    • Addressing practice variations is key to improving healthcare access and outcomes in rural settings.