Child/Adolescent Health

Study provides the first national estimates of the average distances that children travel to see a pediatric subspecialist

The majority of U.S. children live within a 1-hour drive to a pediatric subspecialist such as neonatologist, pediatric cardiologist, or pediatric oncologist. However, care is less widely available for certain subspecialties and in certain regions, according to the first national estimate of the distances U.S. children travel to pediatric subspecialists. The study revealed that the average distance to a subspecialist ranged from 15 miles for neonatology to 78 miles for pediatric sports medicine. For most pediatric subpecialties, more than two-thirds of children lived within 40 miles of a certified physician.

Although the practice locations of pediatric subspecialists paralleled the geographic distribution of children in the United States, many hospital referral regions lacked certain pediatric subspecialists. For example, fewer than one-half of hospital referral regions had a provider for 7 of 16 pediatric subspecialties. These findings suggest that either the supply of pediatric subspecialists in inadequate, pediatric subspecialists are distributed inequitably, or the market for pediatric subspecialists is larger than the hospital referral regions, concludes Michelle L. Mayer, Ph.D., M.P.H., R.N., of the University of North Carolina at Chapel Hill.

Dr. Mayer used data from the American Board of Pediatrics and another database to calculate subspecialty-specific straight-line distances between each zip code and the nearest board-certified specialists. She also used these data to estimate the percentage of hospital referral regions with pediatric subspecialists and to calculate physician-to-population ratios for each of 16 pediatric medical subspecialties. The study was supported by the Agency for Healthcare Research and Quality (HS13309).

More details are in "Are we there yet? Distance to care and relative supply among pediatric medical subspecialties," by Dr. Mayer, in the December 2006 Pediatrics 118(6), pp. 2313-2321.

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