title: Urban/rural differences in the use of physician services by people with multiple sclerosis.
abstract: OBJECTIVE
  to identify any urban/rural differences among people with multiple sclerosis (MS) in the utilization of physician services and MS-focused care, as well as differences in patient perceptions of access and quality.
  
  
  METHODS
  data were collected by surveying 1,518 people with MS throughout the United States, equally divided among urban, urban-adjacent rural areas, and more remote rural areas. Standard SAS procedures were used to analyze the results.
  
  
  RESULTS
  significantly larger proportions of people with MS in rural areas had a family or general practitioner as their primary physician while a significantly larger proportion of people with MS in urban areas had a neurologist as their primary physician. Rural residents traveled significantly greater distances to receive MS-focused care than their urban counterparts. People with MS living in more remote rural areas averaged less satisfaction with their access to a neurologist and to MS-focused care, and less satisfaction with the quality of care received, than people with MS in urban areas.
  
  
  CONCLUSIONS
  limited availability of MS specialists in rural areas, and greater travel time and distance required to receive care from these providers, present future challenges to providing appropriate and high quality MS-focused care to people living with MS in rural areas.
authors.affiliation: Department of Political Science and Public Administration, P.O. Box PC, Mississippi State University, Mississippi State, MS 39762, USA. rjb161@ps.msstate.edu
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Buchanan
authors.forename: Suojin
authors.initials: S
authors.lastname: Wang
authors.forename: Alexa
authors.initials: A
authors.lastname: Stuifbergen
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Chakravorty
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
authors.forename: Myungsuk
authors.initials: M
authors.lastname: Kim
mesh_terms: D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D019037:Urban Health Services / Q000706:statistics & numerical data*