Rural-Urban Disparities in Medicare Post-Acute Therapy Utilization 2013-2021

2013-2021 county-level data quantifies rural-urban disparities in post-acute therapy utilization among Medicare Fee-For-Service beneficiaries. The analysis focuses on therapy minutes from Inpatient Rehabilitation Facilities, Skilled Nursing Facilities, and Home Health Agencies, adjusted for Hierarchical Condition Category risk scores. It supports hierarchical regression and spatiotemporal hot spot analysis to identify clusters of low utilization.

Use Cases

• Perform hierarchical linear regression with county therapy utilization rate as the dependent variable and rural residency indicators as independent variables.
• Conduct spatiotemporal emerging hot spot analysis to map counties with persistent or intensifying low therapy utilization trends from 2013 to 2021.
• Build choropleth maps intersecting county-level therapy utilization rates with rural area gradients to visualize geographic disparities.
• Analyze the interaction between years and rurality to test for changes in utilization disparities, stratified by pre-pandemic (2013-2019) and post-pandemic (2020-2021) periods.

Strengths

• Data spans a 9-year time range from 2013 to 2021, enabling longitudinal analysis of trends.
• Utilization metrics are adjusted for Hierarchical Condition Category (HCC) risk scores, improving comparability.
• Analysis is conducted at both county and state geographic levels, allowing for granular spatial examination.

Limitations

• The dataset's row count and specific column structure are unknown, limiting assessment of its scale and feature completeness.
• Data is aggregated at the county and state level, preventing analysis of individual patient records or beneficiary-level characteristics.
• The description does not specify the file formats or data size, which may complicate integration into analysis workflows.

Provenance

Source

ICPSR Harvested Dataverse, authored by Tiago Jesus.

Collection Method

Aggregated from public domain data on Medicare Fee-For-Service beneficiaries, including Part A post-acute therapy minutes.

Time Range

2013 to 2021.

Freshness

Data covers up to 2021, with metadata last updated in February 2026.

Geography

United States, at county and state levels.