Differences by Rurality in Satisfaction with Care Among Medicare Beneficiaries

Abstract: 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. 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. 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. 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.

Published in: Journal of Rural Health