Who Serves Where: A Geospatial Analysis of Access to Endocrine Surgeons in the United States and Puerto Rico.

Autor: Alterio MM; Washington State University Elson S. Floyd College of Medicine, Spokane, WA., Tobias M; UCDavis DataLab, Data Science and Informatics, University of California Davis, Davis, CA., Koehl A; UCDavis DataLab, Data Science and Informatics, University of California Davis, Davis, CA., Woods AL; Department of Surgery, University of California Davis Medical Center, Sacramento, CA., Sun K; Department of Surgery, University of California Davis Medical Center, Sacramento, CA., Campbell MJ; Department of Surgery, University of California Davis Medical Center, Sacramento, CA., Graves CE; Department of Surgery, University of California Davis Medical Center, Sacramento, CA. Electronic address: cegraves@ucdavis.edu.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2024 Jan; Vol. 175 (1), pp. 32-40. Date of Electronic Publication: 2023 Nov 05.
DOI: 10.1016/j.surg.2023.06.055
Abstrakt: Background: The association between surgical volume and patient outcome is well established, with higher case volume associated with a lower risk of complications. We hypothesized that the geographic distribution of endocrine/head and neck surgeons with an endocrine focus in the United States and Puerto Rico may limit access to many potential patients, particularly in rural areas.
Methods: We used web-based directories from the American Association of Endocrine Surgeons, American Head and Neck Society, and the American Academy of Otolaryngology-Head and Neck Surgery to identify endocrine surgery specialists in the United States and Puerto Rico. Using geographic coordinates and OpenStreetMap and Valhalla software, we calculated the areas within a 60-, 90-, or 120-minute driving distance from specialist offices. We used 2020 U.S. Census Data to calculate census tract populations inside or outside the accessible areas.
Results: Excluding duplicate providers across organizations, we geocoded 603 specialist addresses in the United States and Puerto. We found that 23.76% (78.3 million) of Americans do not have access to a society-affiliated endocrine/head and neck surgeon with an endocrine focus within a 60-minute drive, 14.37% (47.4 million) within a 90-minute drive, and 8.38% (27.6 million) within a 120-minute drive. We observed that the areas of coverage are primarily focused on metropolitan areas.
Conclusion: Nearly one-third of Americans do not have access to a society-affiliated endocrine/head and neck surgeon with an endocrine focus within a 1-hour drive, highlighting a concerning geographic barrier to care. Further work is needed to facilitate patient access and mitigate disparities in quality care.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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