Differences by Rurality in Satisfaction with Care Among Medicare Beneficiaries

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PURPOSE: There are stark differences between rural and urban areas in demographic characteristics, health status, and health care, yet less is known about rural-urban differences in Medicare beneficiaries' satisfaction with care. We seek to identify rural-urban differences in satisfaction with care for Medicare beneficiaries and whether those differences are explained by differences in beneficiary characteristics.

METHODS: We used data from the 2016 Medicare Current Beneficiary Survey (n = 10,625), in which beneficiaries indicated their level of satisfaction for 9 measures related to quality and access/affordability of care. We first assessed bivariate differences in satisfaction with care by rural-urban location (metropolitan, rural micropolitan, and rural noncore) across each measure. We then used logistic regression to assess whether differences remained after adjusting for sociodemographic and health characteristics.

RESULTS: For nearly all measures, satisfaction with care decreased with increasing rurality. Differences in satisfaction persisted for satisfaction with ease of getting to the doctor from home (adjusted odds ratio [AOR] micropolitan: 0.63, P = .037; AOR noncore: 0.61, P = .023) and availability of care by specialists (AOR micropolitan: 0.51, P = .001; AOR noncore: 0.61, P < .001) after adjusting for sociodemographic and health characteristics.

CONCLUSIONS: Rural Medicare beneficiaries reported lower satisfaction with care than their urban counterparts across a variety of measures, and some of these differences remained after adjustments were made for sociodemographic and health characteristics. These findings may have implications for access to and quality of care that rural Medicare beneficiaries receive and their subsequent health outcomes.

Original languageEnglish (US)
Pages (from-to)114-123
Number of pages10
JournalJournal of Rural Health
Issue number1
StatePublished - Jan 1 2021

Bibliographical note

Funding Information:
This study was supported by the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), and U.S. Department of Health and Human Services (HHS) under PHS Grant No. 5U1CRH03717. The information, conclusions, and opinions expressed in this manuscript are those of the authors and no endorsement by FORHP, HRSA, or HHS is intended or should be inferred.

Publisher Copyright:
© 2020 National Rural Health Association


  • Medicare
  • access
  • rural
  • satisfaction with care
  • Rural Population
  • United States
  • Humans
  • Surveys and Questionnaires
  • Aged
  • Health Status
  • Personal Satisfaction

PubMed: MeSH publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Journal Article


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