Trends in Special Medicare Payments and Service Utilization for Rural Areas in the 1990s

By Donna O. Farley; Lisa R. Shugarman et al. | Go to book overview

3.
CHARACTERISTICS OF U.S. METROPOLITAN
AND NON-METROPOLITAN COUNTIES
This section provides background information on the distributions of counties by the metropolitan and non-metropolitan categories used in this research and on their characteristics with respect to population size, designations of underserved areas, and supply of health care providers. This information provides context for the study, and a number of the measures presented also are used in analyses reported in subsequent sections. The analyses were designed to address the following research questions:
To what extent do the non-metropolitan counties vary by extent of rurality, as measured bytheUICs?
What are the demographic and socioeconomic characteristics of non-metropolitan counties and how do these characteristics vary by county categories based on UICs?
What proportion of non-metropolitan counties are underserved areas, designated as HPSAs or MUAs, by county category, and how do those designations differ?
What is the supply of health care providers for non-metropolitan counties, and how does supply vary by county category?

PROFILES OF RURAL AND METROPOLITAN COUNTIES

County Distributions by Metropolitan and Rural Locations

As shown in Table 3.1, 73.3 percent of the U.S. counties are categorized as nonmetropolitan based on the Urban Influence Codes. Non-metropolitan counties that do not contain a city of at least 10,000 population represent 57.8 percent of all counties (24.0 percent are adjacent to MSAs and 33.8 percent are remote counties). Large metropolitan counties are 9.9 percent of the total, and small metropolitan counties are another 16.8 percent of the total. However, the metropolitan counties have much larger total populations and Medicare populations than the non-metropolitan counties.

Counties that qualified as frontier counties because of low population densities represent 12.1 percent of the counties, as shown in Table 3.2. Of these frontier counties, 58.9 percent are classified as remote counties with no town, and the rest are other categories of non-metropolitan counties. The sole exception is Nye County, Nevada, which is a metropolitan county that qualified as a frontier county (a status that held for both the 1990 census population and the 1997 population estimates).

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