Affiliations: [a] Department of Political Science and Public Administration, P.O. Box PC, Mississippi State University, Mississippi State, MS 39762, USA. Tel.: +1 662 325 9318; Fax: +1 662 325 2716; E-mail: rjb161@ps.msstate.edu | [b] Department of Statistics, Texas A&M University, TX, USA | [c] School of Nursing, University of Texas at Austin, Austin, TX, USA | [d] Department of Health Care Administration and Health Sciences, Tennessee State University, TN, USA | [e] Department of Epidemiology and Biostatistics, Texas A&M University System Health Sciences Center, TX, USA
Correspondence:
[*]
Corresponding author
Abstract: Objective:to identify any urban/rural differences among people with multiple sclerosis (MS) in the utilization of physician services and MS-focused care, as well as differences in patient perceptions of access and quality. Method:data were collected by surveying 1,518 people with MS throughout the United States, equally divided among urban, urban-adjacent rural areas, and more remote rural areas. Standard SAS procedures were used to analyze the results. Results:significantly larger proportions of people with MS in rural areas had a family or general practitioner as their primary physician while a significantly larger proportion of people with MS in urban areas had a neurologist as their primary physician. Rural residents traveled significantly greater distances to receive MS-focused care than their urban counterparts. People with MS living in more remote rural areas averaged less satisfaction with their access to a neurologist and to MS-focused care, and less satisfaction with the quality of care received, than people with MS in urban areas. Conclusion:limited availability of MS specialists in rural areas, and greater travel time and distance required to receive care from these providers, present future challenges to providing appropriate and high quality MS-focused care to people living with MS in rural areas.
Keywords: Multiple sclerosis, physician services, specialty care, urban/rural
