Orthopaedic Surgeon Distribution in the United States.

Area of Science:

• Health Services Research
• Medical Geography
• Orthopaedic Surgery Workforce Analysis

Background:

• Limited research exists on the supply and distribution of orthopaedic surgeons in the United States.
• Understanding these patterns is crucial for addressing healthcare disparities.

Purpose of the Study:

• To analyze the association between orthopaedic surgeon distribution and geographic/sociodemographic factors in the US.
• To identify key determinants of orthopaedic surgeon density at the county level.

Main Methods:

• Utilized county-level data from the US Department of Health and Human Services Area Health Resources Files (2000-2019).
• Employed bivariate and multivariable negative binomial regression models to assess surgeon density.
• Examined trends in orthopaedic surgeon distribution over two decades.

Main Results:

• In 2019, 51% of US counties lacked an orthopaedic surgeon.
• Metropolitan counties had significantly higher surgeon density (22/100,000) compared to nonmetropolitan (2/100,000) and rural (0.1/100,000) areas.
• Surgeon density correlated positively with median home value and household income, and negatively with poverty and unemployment rates.

Conclusions:

• Access to orthopaedic surgeons is diminishing in rural US areas.
• County-level socioeconomic factors, including wealth and urbanization, are strongly linked to orthopaedic surgeon density.
• Findings highlight significant geographic and socioeconomic disparities in orthopaedic care access.