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In fact, nine states do not have a single pediatric dermatologist.
The findings come from a cross-sectional analysis of national data presented by Sepideh Ashrafzadeh at the virtual annual meeting of the Society for Pediatric Dermatology.
“Nearly 82% of pediatricians report that their patients have difficulty accessing pediatric dermatologists [and] over 25% of pediatric dermatologists have a wait time of greater than 10 weeks for new patient appointments,” Ms. Ashrafzadeh, a student at Harvard Medical School, Boston, and associates wrote in their poster abstract. “While the shortage of pediatric dermatologists is well documented, little is known about the distribution of pediatric dermatologists across the U.S., which in turn affects families’ travel time and access to pediatric dermatologists. Defining the specific regions with greatest need for pediatric dermatology can help shape recruitment efforts and initiatives to increase access to pediatric dermatologists in areas with the greatest need.”
For the current study, the researchers drew from the SPD Directory in March 2020 to identify all U.S. board-certified pediatric dermatologists. They used the 2020 American Board of Pediatrics Directory and the 2020 Centers for Medicaid & Medicare Physician Compare Database to identify pediatric generalists, which were defined as pediatricians and family medicine physicians. They used the 2018 American Community Survey, published by the U.S. Census Bureau, to obtain the number of children ages 0-17 years in each county and state.
Next, Ms. Ashrafzadeh and colleagues tabulated the number of children, pediatric dermatologists, and pediatric generalists in each county and state, and calculated ratios of pediatric dermatologists and generalists to number of children. The Gini index, a standardized scale where 0 signifies equal distribution and 1 signifies complete maldistribution, was calculated for pediatric dermatologists and generalists relative to the population of children at the state level.
Of the 317 pediatric dermatologists included in the analysis, 243 (77%) were female, 194 (61%) worked in an academic center, and 311 (98%) worked in a metropolitan county. A pediatric dermatologist was present in 41 of 50 states (82%) and in 142 of 3,228 counties (4%). There was not a single pediatric dermatologist in 73 out of 158 counties (46%) with over 100,000 children, 19 out of 66 counties (29%) with over 200,000 children, and 4 out of 13 counties (31%) with over 500,000 children. Nine states had no pediatric dermatologists: Delaware, Idaho, Maine, Mississippi, Montana, Nevada, North Dakota, South Dakota, and Wyoming. States with the greatest density of pediatric dermatologists (range, 10.1-15.2 pediatric dermatologists per 1,000,000 children) were Wisconsin, Massachusetts, Rhode Island, and New Hampshire. The Gini index for the distribution of pediatric dermatologists relative to the population of children was 0.488, compared with 0.132 for that of pediatric generalists.
“To address the unmet pediatric dermatology need, educators and policymakers can create initiatives to recruit pediatric dermatologists and expand access to telehealth pediatric dermatology services in these high priority states and counties,” the researchers wrote in their abstract. “Future studies need to be done quantifying travel distances to pediatric dermatologists across the US as travel distances can further identify areas that are in great need of pediatric dermatologists.”
They acknowledged certain limitations of the study, including the fact that they may have missed board-certified pediatric dermatologists who are not listed in the SPD Directory. Ms. Ashrafzadeh and colleagues reported having no financial disclosures.
In fact, nine states do not have a single pediatric dermatologist.
The findings come from a cross-sectional analysis of national data presented by Sepideh Ashrafzadeh at the virtual annual meeting of the Society for Pediatric Dermatology.
“Nearly 82% of pediatricians report that their patients have difficulty accessing pediatric dermatologists [and] over 25% of pediatric dermatologists have a wait time of greater than 10 weeks for new patient appointments,” Ms. Ashrafzadeh, a student at Harvard Medical School, Boston, and associates wrote in their poster abstract. “While the shortage of pediatric dermatologists is well documented, little is known about the distribution of pediatric dermatologists across the U.S., which in turn affects families’ travel time and access to pediatric dermatologists. Defining the specific regions with greatest need for pediatric dermatology can help shape recruitment efforts and initiatives to increase access to pediatric dermatologists in areas with the greatest need.”
For the current study, the researchers drew from the SPD Directory in March 2020 to identify all U.S. board-certified pediatric dermatologists. They used the 2020 American Board of Pediatrics Directory and the 2020 Centers for Medicaid & Medicare Physician Compare Database to identify pediatric generalists, which were defined as pediatricians and family medicine physicians. They used the 2018 American Community Survey, published by the U.S. Census Bureau, to obtain the number of children ages 0-17 years in each county and state.
Next, Ms. Ashrafzadeh and colleagues tabulated the number of children, pediatric dermatologists, and pediatric generalists in each county and state, and calculated ratios of pediatric dermatologists and generalists to number of children. The Gini index, a standardized scale where 0 signifies equal distribution and 1 signifies complete maldistribution, was calculated for pediatric dermatologists and generalists relative to the population of children at the state level.
Of the 317 pediatric dermatologists included in the analysis, 243 (77%) were female, 194 (61%) worked in an academic center, and 311 (98%) worked in a metropolitan county. A pediatric dermatologist was present in 41 of 50 states (82%) and in 142 of 3,228 counties (4%). There was not a single pediatric dermatologist in 73 out of 158 counties (46%) with over 100,000 children, 19 out of 66 counties (29%) with over 200,000 children, and 4 out of 13 counties (31%) with over 500,000 children. Nine states had no pediatric dermatologists: Delaware, Idaho, Maine, Mississippi, Montana, Nevada, North Dakota, South Dakota, and Wyoming. States with the greatest density of pediatric dermatologists (range, 10.1-15.2 pediatric dermatologists per 1,000,000 children) were Wisconsin, Massachusetts, Rhode Island, and New Hampshire. The Gini index for the distribution of pediatric dermatologists relative to the population of children was 0.488, compared with 0.132 for that of pediatric generalists.
“To address the unmet pediatric dermatology need, educators and policymakers can create initiatives to recruit pediatric dermatologists and expand access to telehealth pediatric dermatology services in these high priority states and counties,” the researchers wrote in their abstract. “Future studies need to be done quantifying travel distances to pediatric dermatologists across the US as travel distances can further identify areas that are in great need of pediatric dermatologists.”
They acknowledged certain limitations of the study, including the fact that they may have missed board-certified pediatric dermatologists who are not listed in the SPD Directory. Ms. Ashrafzadeh and colleagues reported having no financial disclosures.
In fact, nine states do not have a single pediatric dermatologist.
The findings come from a cross-sectional analysis of national data presented by Sepideh Ashrafzadeh at the virtual annual meeting of the Society for Pediatric Dermatology.
“Nearly 82% of pediatricians report that their patients have difficulty accessing pediatric dermatologists [and] over 25% of pediatric dermatologists have a wait time of greater than 10 weeks for new patient appointments,” Ms. Ashrafzadeh, a student at Harvard Medical School, Boston, and associates wrote in their poster abstract. “While the shortage of pediatric dermatologists is well documented, little is known about the distribution of pediatric dermatologists across the U.S., which in turn affects families’ travel time and access to pediatric dermatologists. Defining the specific regions with greatest need for pediatric dermatology can help shape recruitment efforts and initiatives to increase access to pediatric dermatologists in areas with the greatest need.”
For the current study, the researchers drew from the SPD Directory in March 2020 to identify all U.S. board-certified pediatric dermatologists. They used the 2020 American Board of Pediatrics Directory and the 2020 Centers for Medicaid & Medicare Physician Compare Database to identify pediatric generalists, which were defined as pediatricians and family medicine physicians. They used the 2018 American Community Survey, published by the U.S. Census Bureau, to obtain the number of children ages 0-17 years in each county and state.
Next, Ms. Ashrafzadeh and colleagues tabulated the number of children, pediatric dermatologists, and pediatric generalists in each county and state, and calculated ratios of pediatric dermatologists and generalists to number of children. The Gini index, a standardized scale where 0 signifies equal distribution and 1 signifies complete maldistribution, was calculated for pediatric dermatologists and generalists relative to the population of children at the state level.
Of the 317 pediatric dermatologists included in the analysis, 243 (77%) were female, 194 (61%) worked in an academic center, and 311 (98%) worked in a metropolitan county. A pediatric dermatologist was present in 41 of 50 states (82%) and in 142 of 3,228 counties (4%). There was not a single pediatric dermatologist in 73 out of 158 counties (46%) with over 100,000 children, 19 out of 66 counties (29%) with over 200,000 children, and 4 out of 13 counties (31%) with over 500,000 children. Nine states had no pediatric dermatologists: Delaware, Idaho, Maine, Mississippi, Montana, Nevada, North Dakota, South Dakota, and Wyoming. States with the greatest density of pediatric dermatologists (range, 10.1-15.2 pediatric dermatologists per 1,000,000 children) were Wisconsin, Massachusetts, Rhode Island, and New Hampshire. The Gini index for the distribution of pediatric dermatologists relative to the population of children was 0.488, compared with 0.132 for that of pediatric generalists.
“To address the unmet pediatric dermatology need, educators and policymakers can create initiatives to recruit pediatric dermatologists and expand access to telehealth pediatric dermatology services in these high priority states and counties,” the researchers wrote in their abstract. “Future studies need to be done quantifying travel distances to pediatric dermatologists across the US as travel distances can further identify areas that are in great need of pediatric dermatologists.”
They acknowledged certain limitations of the study, including the fact that they may have missed board-certified pediatric dermatologists who are not listed in the SPD Directory. Ms. Ashrafzadeh and colleagues reported having no financial disclosures.
FROM SPD 2020