Disparities in Geographic Access to Pediatric Subspecialty Care
- Michelle L. Mayer
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Purpose: To identify correlates of geographic access to pediatric medical subspecialists in the United States and identify characteristics of populations at risk for poor geographic access. Methods: Geographic access was operationalized as distance to care. Using data from the American Board of Pediatrics and the Claritas’ Pop-Facts Database, the straight-line distance between each zip code in the United States and the nearest subspecialist was calculated for each pediatric subspecialty using zip code centroids. Using 16 specialty-specific, random-effects multiple regression models, zip code characteristics associated with being farther from a subspecialty provider were identified. Results: Under-18 population, metropolitan status, and presence of a nearby teaching facility were associated with shorter distances to care across pediatric subspecialties. The proportion of the population below the federal poverty level was positively associated with greater distances to care. Zip codes in the Mountain and West North Central regions, likewise, were significantly farther from pediatric subspecialists, even when statistically controlling for other factors. Conclusions: Pediatric populations at risk for poor geographic access to pediatric subspecialty care include those who reside in zip codes with high concentrations of poverty, in rural and small metropolitan areas, and in the Mountain and West North Central regions. The extent to which these distances create barriers to receipt of care is not established.
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- Disparities in Geographic Access to Pediatric Subspecialty Care
Maternal and Child Health Journal
Volume 12, Issue 5 , pp 624-632
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Pediatric subspecialties
- Health care disparities
- Rural health services
- Health services accessibility
- Industry Sectors
- Michelle L. Mayer (1) (2)
- Author Affiliations
- 1. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- 2. Department of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill, CB 7590, Chapel Hill, NC, 27599-7590, USA