Do Rural Georgians Experience Disparities in Access to Healthcare? An Assessment of the Impact of the Patient Protection and Affordable Care Act for Individuals in Rural Georgia
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Authors
Grams, Celia Marlene Claborn
Issue Date
2022-05
Type
Dissertation
Language
en_US
Keywords
Dissertations, Academic--United States , Georgia , Health insurance , Patient Protection and Affordable Care Act (United States) , Public Administration , Public health , Rural health services
Alternative Title
Abstract
This study examines the relationships between (a) having insurance, (b) foregoing care due to cost, and (c) having a usual source of care, and location and/or passage of the Patient Protection and Affordable Care Act (ACA) for residents in Georgia. Data for these variables were taken from the years 2005–2009 (years preceding the ACA reform) and 2011–2017 (years after the ACA reform). Relationships between the variables were assessed for statistical significance using Pearson’s chi squared (χ2) test and a multivariable regression analysis. The study used publicly available secondary data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. The quantitative data sets analyzed for this study provided insights into healthcare accessibility and affordability for Georgia’s rural and urban populations. Stata statistical software was used to analyze the data and test statistical significance. Pre-ACA percentages for having insurance for rural Georgians ranged from a mean value and standard deviation of 79.6% ± 1.67%, dropped to 69.3% in 2011, and returned to pre-ACA values after 2014. Foregoing care pre-ACA values of 19.0% ± 1.45% increased to 26.9% in 2011 and dropped to pre-ACA values after 2014. In contrast, usual source of care results showed pre-ACA values of 82.1% ± 0.97% with post-ACA values of 72.1% ± 1.25%. The 10% decrease is a permanent change. This study showed that disparities affected all demographic characteristics, such as age, race, marital status, education, and gender, which may be determinants for health-related behaviors for both rural and urban communities.
Keywords: Affordable Care Act, Healthcare, Insurance, Health-related behavior, Rural, Medicaid
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This dissertation is protected by the Copyright Laws of the United States (Public Law 94-553, revised in 1976). Consistent with fair use as defined in the Copyright Laws, brief quotations from this material are allowed with proper acknowledgement. Use of the materials for financial gain with the author's expressed written permissions is not allowed.