Urban/Rural Differences in Hospital Admissions with Multiple Sclerosis in Selected Counties in Ohio 1999-2004

Sadik A. Khuder*, 1, Melissa Foos1, Nabeel A. Herial§, 1, Anand B. Mutgi§, 1, Basil S. Khuder§, 1, Rose Jung§, 2
1 College of Medicine, University of Toledo, Toledo, Ohio, USA
2 College of Pharmacy, University of Toledo, Toledo, Ohio, USA

© 2009Khuder et al..

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the College of Medicine, University of Toledo, Toledo, Ohio, USA;Tel: 419-383-4089; Fax: 419-383-6244; E-mail:



Regional differences in the prevalence of Multiple Sclerosis (MS) have been reported with higher rates in rural areas.


Using hospital admission data from eight counties in Ohio (1999 to 2004), we described the pattern of admissions for MS patients and examined the rural/urban differences.


Adjusted admission rate ratios (ARR) for rural regions were calculated using Poisson regression models.


The estimated admission rate was 70 per 100,000 in 1999 and increased to 90 per 100,000 in 2004 (p<0.0001). A significant association between degree of urbanization and MS admission rates was found with higher rate in rural area (ARR=1.23, 95% CI 1.17-1.35) and in female (ARR=2.45, 95% CI 2.37-2.54).


Admission rate for MS is increasing and rural residence is associated with higher hospitalization rate.

Keywords: Multiple Sclerosis, hospital admission, urban, rural.