Many smaller, nonrural regions of the United States have no or few practicing rheumatologists, limiting access for patients with chronic rheumatic conditions, according to recent study results.
“Our study highlights that regional shortages of rheumatologists already exist,” John D. FitzGerald, MD, PhD, of UCLA Rheumatology, David Geffen School of Medicine, said in a press release. “There are a number of communities across the US that would benefit from additional rheumatology services.”
John D. FitzGerald
FitzGerald and colleagues used the American College of Rheumatology membership database to map all adult practicing rheumatologist office addresses. They then tallied the number of rheumatologists per core-based statistical area (CBSA), which included metropolitan (populations of 50,000 or more) and micropolitan (populations of at least 10,000, but fewer than 50,000) areas. Other regions were defined as rural.
Covariates from the 2010 US Census for each CBSA, including age, gender, race/ethnicity and median household income, were used to study if socio-demographic factors correlated with clustering of rheumatologists.
Three hundred sixty metropolitan areas (83% of the population) and 573 micropolitan areas (10% of the population) were identified. Rural regions comprised 7% of the population.
Of the 3,920 practicing adult rheumatologists in the ACR database, 90% practiced in metropolitan areas; 3%, in micropolitan areas; and 7%, in rural areas. Eighty-four percent of micropolitan areas did not have a rheumatologist, compared with 9% of metropolitan areas. One percent of metropolitans had travel distances of greater than 75 miles to the nearest practicing rheumatologist, compared with 16% of micropolitans, who in some cases were more than 200 miles away.
Areas with higher population densities and higher median incomes were more likely to have greater numbers of practicing rheumatologists.
“In evaluating the rheumatology workforce, the distribution of workforce and small-area analyses are critical to identify regions of underserved populations,” the researchers concluded. “However, better information is needed about factors that affect access to rheumatologists in underserved areas including information about physician practices.”
Disclosure: The researchers report no relevant financial disclosures.