Urban-rural differences in work disability following occupational injury: are they related to differences in healthcare utilization?

Abstract

To investigate urban-rural differences in health care utilization following compensable work-related injury and determine whether differences relate to work disability. 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. 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. 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.