Table 4.
Association between rurality and system- and individual-level barriers reported by household respondents, Washington State, 2018 to 2019.
| RUCA 4-tier | RUCA 2-tier | RUCC 2-tier | ||||||
|---|---|---|---|---|---|---|---|---|
| Urban | Suburban | Large rural | Small rural | Urban | Rural | Metro | Non-metro | |
| System-level barriers | ||||||||
| No appointment times that fit their schedule a | Ref | 0.69 (0.30-1.60) | 0.91 (0.38-2.18) | 0.75 (0.35-1.62) | Ref | 0.88 (0.45-1.70) | Ref | 1.03 (0.51-2.06) |
| No PCP in their local area a | Ref | 0.75 (0.12-4.68) | 2.31 (0.31-17.33) | 11.37 (3.03-42.75) | Ref | 5.25 (1.35-20.36) | Ref | 5.73 (1.41-23.22) |
| Lacked access to preventive care b | Ref | 0.14 (0.01-1.53) | 4.19 (0.89-19.72) | 7.31 (1.84-29.09) | Ref | 5.88 (1.63-21.23) | Ref | 6.44 (1.88-22.04) |
| Accessed non-emergency care in the emergency room because they were unable to see a PCP b | Ref | 0.78 (0.32-1.92) | 0.59 (0.24-1.46) | 1.11 (0.54-2.29) | Ref | 0.79 (0.41-1.53) | Ref | 1.02 (0.51-2.06) |
| PCP was not accepting new patients a | Ref | 0.52 (0.13-2.00) | 3.94 (1.38-11.26) | 1.67 (0.62-4.54) | Ref | 3.11 (1.31-7.38) | Ref | 3.95 (1.64-9.49) |
| Needed medical care was too far away to access c | Ref | 1.35 (0.21-8.57) | 1.11 (0.15-8.03) | 7.41 (1.59-34.43) | Ref | 3.07 (0.81-11.63) | Ref | 2.67 (0.72-9.90) |
| Individual barriers | ||||||||
| Inability to pay for services a | Ref | 0.48 (0.15-1.56) | 0.43 (0.12-1.50) | 0.60 (0.22-1.67) | Ref | 0.52 (0.21-1.33) | Ref | 0.66 (0.26-1.64) |
| Delayed or canceled a surgical procedure due to lack of ability to pay b | Ref | 0.55 (0.18-1.64) | 0.52 (0.15-1.81) | 0.62 (0.22-1.73) | Ref | 0.61 (0.24-1.54) | Ref | 0.69 (0.27-1.78) |
| Inability to take time off work a | Ref | 0.45 (0.14-1.49) | 0.70 (0.20-2.46) | 0.39 (0.11-1.38) | Ref | 0.65 (0.23-1.79) | Ref | 0.80 (0.29-2.24) |
| Uninsured a | Ref | 0.36 (0.08-1.76) | 0.52 (0.10-2.75) | 0.74 (0.19-2.90) | Ref | 0.68 (0.20-2.31) | Ref | 1.06 (0.33-3.48) |
| Uninsureda,c | Ref | 0.49 (0.11-2.10) | 0.75 (0.15-3.67) | 0.80 (0.24-2.72) | Ref | 0.83 (0.26-2.71) | Ref | 1.11 (0.32-3.85) |
| Primary health care provider not accepting patients with your insurance plan a | Ref | 0.40 (0.10-1.71) | 1.40 (0.36-5.36) | 1.12 (0.36-3.48) | Ref | 1.42 (0.51-3.96) | Ref | 1.85 (0.66-5.17) |
Abbreviations: Metro, metropolitan; PCP, primary care provider; RUCA, rural-urban commuting area classification scheme based on ZIP codes; RUCC, rural-urban commuting code classification scheme based on county; Sig, significance.
Values represent survey-weighted multivariable regression model results, adjusted odds ratios and 95% confidence interval. Multivariable models adjust for sex, age, race, employment, and insurance status.
Reported reasons why respondents were unable to see a PCP in the last 12 months.
Reported health situation reported as a problem by respondents in the past year.
Excluding insurance status as a covariate.