title: Out-of-pocket health spending and the rural underinsured.
abstract: Multiple studies have documented higher uninsurance rates among rural compared to urban residents, yet the relative adequacy of coverage among rural residents with private health insurance remains unclear. This study estimates underinsurance rates among privately insured rural residents (both adjacent and nonadjacent to urban areas) and the characteristics associated with rural underinsurance. We found that 6 percent of privately insured urban residents were underinsured; the rate increased to 10 percent for rural adjacent and 12 percent for rural nonadjacent residents. Multivariate analyses suggest that rural residents' underinsurance status is related to the design of the private plans through which they have coverage.
authors.affiliation: Institute for Health Policy, Muskie School of Public Service, University of Southern Maine, Portland, USA. eziller@usm.maine.edu
authors.forename: Erika C
authors.initials: EC
authors.lastname: Ziller
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Coburn
authors.forename: Anush E
authors.initials: AE
authors.lastname: Yousefian
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D019035:Rural Health Services / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States