Rural Representation: Factors Associated With Geographic Distribution of Plastic Surgeons in Rural United States...

Area of Science:

• Health Services Research
• Surgical Specialties
• Rural Health

Background:

• Rural populations in the US face healthcare disparities, notably limited access to plastic and reconstructive surgery (PRS).
• Understanding the geographic distribution of PRS providers is crucial for addressing these disparities.

Purpose of the Study:

• To map the geographic distribution of board-certified plastic and reconstructive surgeons in the US.
• To identify factors associated with the presence of PRS in rural counties.

Main Methods:

• Identified American Society of Plastic Surgeons members in December 2023.
• Utilized the 2022 Area Health Resource File for county demographics and health resources.
• Classified rurality using the National Center for Health Statistics Urban-Rural Classification Scheme and employed statistical tests for analysis.

Main Results:

• 3913 surgeons served 626 (20%) US counties, covering 75% of the population.
• Only 5% of rural counties had a PRS provider, compared to 46% of urban counties (P < 0.001).
• Access in rural areas correlated with ambulatory surgery centers (aOR: 1.80), dermatology (aOR: 2.12), and radiation oncology (aOR: 2.16).

Conclusions:

• Significant geographic disparities in PRS access exist, with 95% of rural counties lacking a surgeon.
• Ambulatory surgery centers, dermatology, and radiation oncology presence enhance the likelihood of PRS access in rural settings.
• Further research is needed to determine strategies for recruiting PRS specialists to underserved rural areas.