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Rural-Urban Differences in Access to Thoracic Surgery in the United States, 2010 to 2014
Journal article   Open access   Peer reviewed

Rural-Urban Differences in Access to Thoracic Surgery in the United States, 2010 to 2014

Jan M Eberth, Elizabeth L Crouch, Michele J Josey, Whitney E Zahnd, Swann Arp Adams, Brendon M Stiles and Mario Schootman
The Annals of thoracic surgery, v 108(4), pp 1087-1093
Oct 2019
DOI: https://doi.org/10.1016/j.athoracsur.2019.04.113
PMID: 31238030
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.athoracsur.2019.04.113View
Published, Version of Record (VoR) Open

Abstract

Early Detection of Cancer Female Health Services Accessibility - statistics & numerical data Humans Lung Neoplasms - diagnosis Lung Neoplasms - epidemiology Lung Neoplasms - surgery Male Morbidity - trends Population Surveillance - methods Retrospective Studies Rural Population Thoracic Surgery, Video-Assisted - statistics & numerical data United States - epidemiology Urban Population
Because of recent lung cancer screening recommendations and corresponding insurance coverage, it is expected that more early stage cases will be identified that require thoracic surgery. However, these services may not be equally available in all regions. Our objective is to describe the availability of thoracic surgeons by examining geographic variation, rural-urban differences, and temporal changes before and after screening recommendation and insurance coverage policy changes. We examined the U.S. thoracic surgery workforce using the 2010 and 2014 Area Health Resource Files. We calculated the density of thoracic surgeons per 100,000 persons for each year at the state and county level. We performed descriptive statistics and developed maps highlighting changes over time and geographic regions. Despite an overall increase in thoracic surgeons from 2010 to 2014, we observed declining density nationwide (1.5% change) and in sparsely populated states. The difference in thoracic surgeon density widened slightly between 2010 from 0.80 per 100,000 compared with 0.84 per 100,000 in 2014 in all rural counties compared with urban counties (P < .001 for both years). The difference in thoracic surgeon density was most pronounced between small adjacent rural and urban counties (0.95 and 0.96 per 100,000 for 2010 and 2014, respectively; P < .001 for both years). The Northeast held a disproportionate share of the thoracic surgery workforce. Limited access to thoracic surgeons in rural areas is a concern, given an older and retiring surgical workforce, the higher burden of lung cancer in rural areas, and recent policy changes for screening reimbursement.

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15 Record Views
20 citations in Web of Science
20 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#5 Gender Equality

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
Respiratory System
Surgery
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