Geospatial Analysis of Orthopedic Workforce Distribution Across Georgia

Healthcare disparities between rural and urban populations have been well documented; however, orthopedic surgery-specific care remains under-characterized in rural communities. The purpose of this study was to assess rural-urban disparities in access to orthopedic care in Georgia.

This is a cross-sectional study.

The Georgia Composite Medical Board database was utilized to identify practicing orthopedic surgeons and their location of practice. County-level demographic data, including population and median household income, were collected from the 2020 United States Census. Counties were stratified using the 2023 Rural-Urban Continuum Codes, and they were sorted into metropolitan (categories one to three) and non-metropolitan counties (categories four to nine). Metrics calculated included orthopedic surgeon density per 100,000 residents, surgeon density per 100 square miles, average travel distance from the county centroid to the nearest orthopedic practice, and income correlation per county.

A total of 838 orthopedic surgeons were identified across Georgia's 159 counties. Metropolitan counties had significantly higher provider density than non-metropolitan counterparts, both per 100,000 residents (4.81 vs. 2.56, p = 0.009) and per 100 square miles (3.07 vs. 0.22, p < 0.001). Rural counties also experienced a greater travel burden to the nearest orthopedic provider (15.85 vs. 8.19 miles, p < 0.001), and fewer counties had at least one orthopedist (34.9% rural vs. 54.1% urban). Correlation analysis revealed that lower income was associated with both greater travel burden (ρ = -0.47, p < 0.001) and lower provider density per capita (ρ = 0.34, p < 0.001).

This study highlights a significant gap in access to orthopedic care between rural and urban counties in Georgia, with individuals in rural counties having limited access to orthopedic care due to longer travel distances and lower surgeon density.