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Published on: September 17, 2013
Travel Distance and Time to Pulsed Dye Laser Treatment for Port-Wine Birthmark in the Pediatric Population
Joseph Masison1, Vijay Kodumudi2, Eric J Beltrami1
1Drs. Masison and Beltrami are with the University of Connecticut School of Medicine in Farmington, Connecticut.
Insights
Children in rural areas and those without insurance face longer travel times for early port-wine birthmark (PWB) treatment with pulsed dye laser (PDL). This highlights access barriers for disadvantaged pediatric populations needing timely PWB therapy.
Area of Science:
- Dermatology
- Medical Geography
- Public Health
Background:
- Early treatment of port-wine birthmarks (PWB) with pulsed dye laser (PDL) is crucial for optimal pediatric outcomes.
- Variations in dermatologist practice patterns for PDL therapy necessitate an understanding of patient access.
Purpose of the Study:
- To analyze travel distance and time to PDL treatment sites for pediatric PWB patients across the United States.
- To identify disparities in access based on geographic location (urban vs. rural) and insurance status.
Main Methods:
- Cross-sectional analysis utilizing ArcGIS to map travel time and distance from US county population centers to the nearest PDL site.
- Data linked to census tract demographics to assess geographic and socioeconomic factors.
- Identification of 1,243 PDL practice sites for pediatric PWB treatment.
Main Results:
- Children in urban areas had significantly shorter median travel times (11.8 minutes) and distances (6.1 miles) compared to rural children (66.7 minutes, 60.9 miles).
- Uninsured children traveled longer average distances (32.2 miles) than insured children (24.2 miles).
Conclusions:
- Socioeconomically disadvantaged pediatric populations, particularly those in rural areas and uninsured, face a greater travel burden for PDL treatment of PWB.
- Targeted transportation resources and support may be necessary to ensure equitable and timely access to essential PWB therapy.
Abstract:
Prior research has demonstrated that early treatment of port-wine birthmark (PWB) with pulsed dye laser (PDL) yields optimal patient outcomes. Given the known variations in practice patterns among dermatologists offering PDL, we conducted a cross-sectional analysis in order to determine the travel distance and time to practice locations offering PDL therapy for PWB among the pediatric population. We determined the travel time and distance from each county population center in the United States to the nearest PDL site using ArcGIS and linked the data to demographic characteristics in each census tract. 1,243 practice sites were identified that offer PDL treatment for PWB for patients under the age of 18. Children living in urban areas were found to have a significantly shorter median travel time and distance to PDL sites (6.1 miles, 11.8 minutes) compared to children living in rural areas (60.9 miles, 66.7 minutes). Additionally, uninsured children were found to travel longer average distances (32.2 miles) than insured children (24.2 miles). These findings suggest that certain socioeconomically disadvantaged groups have increased travel burden when obtaining PDL treatment for PWB. Transportation resources and support may need to be given to certain patients to ensure timely and effective PDL treatment.
