From "Characteristics of Rural Children Admitted to Pediatric Hospitals" by Alon Peltz et al in Pediatrics, April, 2016:
Background-"Delivering high-quality care to children living in rural areas can be challenging. Compared with non-rural children, rural children often experience worse health outcomes. We assessed characteristics and hospitalizations of rural children admitted to US children's hospitals in 2012."
Conclusions-"Rural children hospitalized at children's hospitals have high rates of medical complexity and often reside in low-income and medically underserved areas. Compared with non-rural children, rural children experience more expensive hospitalization and more frequent readmissions."
Discussion-The majority of hospitalized rural children in the current study resided in neighborhoods with high levels of poverty. It is well known that financial challenges of patients and families contribute to suboptimal health and health care outcomes. For rural families in low-income neighborhoods caring for a recently hospitalized child with chronic illness could lead to additional financial stress, especially if higher out-of-pocket health care expenses are incurred. Furthermore, some of these areas may not have access to local social work or care management services for help. As a result, rural children from economically challenged families may experience difficulties adhering to a discharge care plan, especially a plan that is associated with copayments for medications, equipment, and follow-up visits."
"Children's hospitals may find the information from the current study useful as they strive to (1) better integrate with their surrounding local and regional care areas and (2) ameliorate disparities in health and quality of care between rural and non-rural children, especially those with complex medical needs."