Association Between Neighborhood Deprivation and Number of Rheumatology Providers

Area of Science:

• Rheumatology
• Health Services Research
• Health Equity

Background:

• Geographic distribution of healthcare providers significantly influences patient access to specialized care.
• Rheumatic diseases require timely and consistent management, making provider distribution critical.
• Existing disparities in rheumatologist distribution may exacerbate health inequities for patients with rheumatic conditions.

Purpose of the Study:

• To analyze the geographic distribution of rheumatologists in relation to the Area Deprivation Index (ADI).
• To identify practice pattern variations among rheumatologists prescribing to Medicare Part D beneficiaries.
• To quantify the relationship between area deprivation and rheumatologist density.

Main Methods:

• Utilized Poisson regression to model the number of rheumatologists based on ADI.
• Analyzed data from 5,882 rheumatologists serving Medicare Part D beneficiaries.
• Compared rheumatologist density across ADI quintiles (0-100 scale, higher score indicates greater deprivation).

Main Results:

• A 10-point increase in ADI was associated with a 20.3% decrease in rheumatologists.
• Areas with the lowest deprivation (quintile 1) had 2.1 times more rheumatologists per capita than the most deprived areas (quintile 5).
• The total number of rheumatologists declined after 2016 across all deprivation levels.

Conclusions:

• Rheumatologists concentrate in less deprived areas, creating significant access disparities.
• The declining rheumatology workforce further intensifies these geographic inequities.
• Policymakers must address these disparities to ensure equitable access to rheumatology care.