Urban-rural differences in physical therapy use among US adults with arthritis

PurposeThe purpose of this study was to analyze differences in physical therapy (PT) use among a nationally representative sample of adults with symptomatic arthritis according to the rurality of their residence. MethodsWe used data from the 2023 National Health Information Survey (adult sample) to identify individuals with symptomatic arthritis by using 2 survey items indicating whether a healthcare provider had diagnosed the participant with arthritis and whether the participant had experienced arthritis-related symptoms during the past 30 days. One survey item was used to identify whether the participant had participated in PT during the previous 12 months. Levels of rurality were defined, in ascending order, as "large central metropolitan," "large fringe metropolitan," "medium or small metropolitan," and "nonmetropolitan/rural," according to each participants county of residence. Univariate and multivariate statistics were used to determine the association of PT use with the level of rurality. National estimates were calculated using weighting variables. FindingsWe identified 5,749 adults (weighted = 40,358,683) meeting our definition of symptomatic arthritis. Compared to those living in large central metropolitan areas, participants living in medium or small metropolitan areas were 20% less likely to report PT use (weighted odds ratio: 0.80; 95% confidence interval: 0.66, 0.96) and those living in nonmetropolitan/rural areas were 30% less likely (weighted odds ratio: 0.70; 95% confidence interval: 0.56, 0.88). ConclusionsAmong adults with symptomatic arthritis, those living in more rural areas had lower odds of PT use than those living in less rural (more urban) areas.