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Published on: December 18, 2016
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Geographic Heterogeneity in Epilepsy Specialist Distribution
Evelyn Gotlieb1, Anne Lally2, Leah J Blank1,3,4
1Icahn School of Medicine at Mount Sinai, New York, NY.
Neurology
|August 26, 2025
Summary
Geographic disparities exist in epilepsy physician supply across the US. Many areas, particularly in the South, face high patient-to-physician ratios, impacting epilepsy care access.
Area of Science:
- Neurology
- Public Health
- Health Services Research
Background:
- Geographic location is a critical determinant of healthcare access.
- Understanding the distribution of specialized medical professionals is essential for equitable care.
Purpose of the Study:
- To quantify the supply and geographic distribution of epilepsy-certified physicians nationwide.
- To identify disparities in physician availability across different regions and socioeconomic contexts.
Main Methods:
- Cross-sectional analysis of active epilepsy-certified physicians using American Board of Psychiatry and Neurology data.
- Mapping physician locations to county-level data, including Area Deprivation Index (ADI) and Urban Influence Codes.
- Calculating patient-to-physician ratios based on regional epilepsy case estimates.
Main Results:
- A total of 2,169 active epilepsy-certified physicians were identified.
- Significant geographic variation was observed, with zero physicians in Montana and limited supply in Arizona, Vermont, and Wyoming.
- The Southern US exhibited the highest epilepsy case burden and patient-to-physician ratios, with a concentration of physicians in metropolitan areas, yet many counties lacked specialists.
Conclusions:
- The study reveals substantial geographic heterogeneity in the supply of epilepsy subspecialists.
- Addressing these distribution inequities is crucial for improving the quality of epilepsy care nationwide.
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