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Rural versus urban differences in healthcare utilization and long-term outcomes in adults with pediatric-onset spinal cord injury.

Kurapati, Nikhil (2018) Rural versus urban differences in healthcare utilization and long-term outcomes in adults with pediatric-onset spinal cord injury. Master Essay, University of Pittsburgh.

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Abstract

Individuals with pediatric-onset spinal cord injury (SCI) require long-term care and have a high risk of secondary health conditions. Individuals with SCI who live in rural areas potentially have unmet medical needs due to insufficiency of medical infrastructure and medical providers, illustrating a significant issue to public health. We studied how factors affecting health usage differed between rural versus urban-living participants with pediatric-onset SCI including patient independence, employment, income, and access to private insurance. In addition, we examined differences in healthcare outcomes such as hospitalizations, paid expenses, urinary tract infections (UTIs), and pressure ulcers.
This study was part of a larger longitudinal study on long-term outcomes of adults with pediatric-onset SCI. Participants (N=471) reported on sociodemographic and injury characteristics and medical outcomes. Participant zip codes were identified as rural or urban using the ProximityOne database based on the ZIP Code Tabulation Areas from the 2010 census.
Those living in rural areas have decreased income, decreased access to private health insurance, fewer hours of paid personal care assistance, and increased incidence of pressure ulcers. There were no differences with respect to incidence of UTIs, hospitalizations or psychosocial functioning. Rural-living individuals with pediatric-onset SCI experience economic barriers to healthcare, but differences in secondary health conditions were limited to increased incidence in pressure ulcers . Addressing known disparities in and obstacles to treatment of SCI due to rurality would have significant positive effects on treatment outcomes and future prevention efforts of secondary conditions, improving the overall health of the public.

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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Kurapati, Nikhilntk7@pitt.eduntk70000-0001-7627-9413
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairFinegold, Daviddnf@pitt.edudnfUNSPECIFIED
Committee MemberFelter, Elizabethemfelter@pitt.eduemfelterUNSPECIFIED
Date: 23 April 2018
Date Type: Completion
Number of Pages: 30
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Multidisciplinary MPH
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 31 May 2019 20:24
Last Modified: 31 May 2019 20:24
URI: http://d-scholarship.pitt.edu/id/eprint/34434

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