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Contextualizing Rural/Non-Rural Differences in Pediatric Primary Care Patterns in South Carolina: A Mixed-Methods
Caitlin Koob1, Kinsey Meggett, Michelle Parisi
1Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, South Carolina (Dr Koob); Department of Public Health Sciences, Clemson University, Clemson, South Carolina (Ms Meggett and Dr Griffin); and Department of Nutritional Sciences, University of Georgia, Athens, Georgia (Dr Parisi).
Background:
In the United States, 30.7% of children aged 10-17 are overweight/obese, increasing their risk of experiencing negative health outcomes. Clinical guidelines urge for frequent visits for preventative weight management. Limited research examines the intersection of primary care patterns and families' perspectives of pediatric primary care in rural South Carolina (SC).
Objectives:
1) Examine rural/non-rural differences in pediatric primary care patterns among Medicaid-insured children, and 2) contextualize differences from families' perspectives.
Methods:
SC Medicaid claims were analyzed among patients who had a weight-related diagnostic code and ≥1 primary care visit in northeastern SC from 2018 to 2022 (N = 22,084). Logistic regression examined associations between patient characteristics and traveling for primary care. Additionally, in-depth interviews (N = 12) were conducted to explore families' perspectives in rural primary care access.
Results:
Overall, 40.54% of children were diagnosed as overweight/obese. Children living in rural counties, younger, non-Hispanic white, and had a healthy weight were most likely to travel for primary care. Rurality influenced the relationship between traveling for care, race/ethnicity, and weight status. Families express limited trust and perceive poor healthcare quality in their community, motivating their willingness to travel for healthcare.
Conclusion:
Findings may inform tailored public health efforts to optimize child and family health across rural SC.
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