Access to Pediatric Asthma Specialty Care: A Survey and Geospatial Analysis Across a Rural State

Area of Science:

• Pediatric Allergy and Immunology
• Pulmonology
• Rural Health Disparities

Background:

• Children with asthma benefit from specialized care from allergist/immunologists and pediatric pulmonologists.
• Access to this specialized care can be limited by geographic proximity, provider acceptance of pediatric patients, and insurance coverage.

Purpose of the Study:

• To determine the geographic accessibility of pediatric asthma specialty care in a rural state.
• To evaluate how provider acceptance of pediatric patients and Medicaid insurance affects access to care.

Main Methods:

• A telephone survey of pediatric pulmonology and allergy/immunology practices in and around Maine was conducted.
• Data collected included provider acceptance of pediatric patients, Maine Medicaid insurance, and appointment wait times. Travel time analysis was performed for children across Maine.

Main Results:

• Of 49 asthma specialists, 84% accepted pediatric patients.
• Only 6% of out-of-state providers accepted children with Maine Medicaid insurance, compared to 89% of in-state providers.
• 18% of children faced travel times exceeding 60 minutes to reach an asthma specialist.

Conclusions:

• Significant barriers exist for children in Maine seeking asthma specialty care, including travel distance and provider acceptance policies.
• Nearly one in five children require over an hour of travel, and many providers do not accept pediatric patients or Medicaid.
• Further research is needed to understand how these access barriers affect children's asthma management and outcomes.