Insurance Coverage and Perceived Access to Care Among Rural Adults: A Cross-Sectional Study Using Andersen's Behavioral Model.

The analysis used 2012-2013 Connecticut survey data, so it may not reflect current insurance coverage, Medicaid expansion, or rural access conditions. The design was cross-sectional, so it cannot show that insurance caused better perceived access. Perceived access was self-reported and may be shaped by prior healthcare experiences or chronic disease burden. The sample was limited to predominantly rural adults in one state, so it may not apply to other rural populations. Missing data were handled by mean substitution for BMI and listwise deletion for other variables. Listwise deletion may have introduced selection bias. The model's Hosmer-Lemeshow test was significant, although the authors attribute this to the large weighted sample. The paper reports different weighted percentages for insurance coverage in the text and Table 1.

This study did not receive a specific grant, and the authors declared no conflicts of interest. The original Connecticut Health Care Survey was supported by six Connecticut health foundations.

Do not conclude that insurance caused better access or that expanding coverage alone will solve rural access problems. This was a cross-sectional survey of perceived access, and it did not test an insurance or care navigation intervention.