title: Urban/rural differences in health insurance coverage among people with multiple sclerosis.
abstract: OBJECTIVE
  To present urban/rural analyses of health insurance coverage among people with multiple sclerosis (MS). This research also combined all survey respondents from each urban/rural area into one group of people with MS in health maintenance organizations (HMOs)/managed care and another group of people with MS who have other health insurance plans to compare any differences in coverage.
  
  
  METHODS
  We interviewed 1,518 people with MS living in all 50 states. Survey results were analyzed using SPSS.
  
  
  RESULTS
  Most people with MS in each urban/rural area had health insurance coverage (92-95%), with significant urban/rural differences observed in HMO/managed care enrollments. We found no urban/rural differences among people with MS in HMOs/managed care, or among people with MS with other health insurance plans, in satisfaction with coverage of routine care and MS-focused care, or with perceptions of how coverage enables utilization of health services. However, we found that people with MS in HMOs/managed care were more satisfied than people with MS with other health insurance with their coverage of routine care and perceived that their coverage enabled greater utilization of routine care and needed medications.
  
  
  CONCLUSIONS
  We found no significant differences in satisfaction with MS-focused care or with perceptions of how well coverage enables utilization of MS-focused care or needed assistive devices between people with MS in HMOs/managed care and people with MS who have other health insurance.
authors.affiliation: Department of Political Science and Public Administration, Mississippi State University, Mississippi State, MS 39762, USA. rjb161@ps.msstate.edu
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Buchanan
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
authors.forename: Wesley
authors.initials: W
authors.lastname: James
mesh_terms: D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health; D009103:Multiple Sclerosis / Q000453:epidemiology*; D017060:Patient Satisfaction; D012424:Rural Population; D014481:United States / Q000453:epidemiology; D014505:Urban Population