title: Urban-rural differences in work disability following occupational injury: are they related to differences in healthcare utilization?
abstract: OBJECTIVE
  To investigate urban-rural differences in health care utilization following compensable work-related injury and determine whether differences relate to work disability.
  
  
  METHODS
  Analysis of worker's compensation data relating to 4889 people with a bone fracture. Regression analyses were used to test the associations between rurality, work disability, and health care utilization.
  
  
  RESULTS
  Place of residence was found to relate to health care utilization and work-disability duration; however, the direction of this relationship depended on the amount of health care used. At lower levels of utilization, more rural residents had less time off; however, as health care usage increased this trend reversed.
  
  
  CONCLUSIONS
  The observed interaction between health care utilization, work-disability, and rurality raises important questions regarding causality and implies that people in both urban and rural areas have the potential to benefit from further investigation into health care practices and associated outcomes.
authors.affiliation: Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA 07148, USA. amandaellenyoung@libertymutual.com
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Young
authors.forename: Manuel
authors.initials: M
authors.lastname: Cifuentes
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Wasiak
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Webster
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000328:Adult; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D012424:Rural Population / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D014942:Workers' Compensation / Q000706:statistics & numerical data*