Related Experiment Video
Updated: Jan 7, 2026
Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
Rural-Urban Disparities in Access to Otolaryngology Care in Louisiana
Elizabeth Bryan1, Mackenzie Latour2, Karuna Dewan2
1Department of Otolaryngology/Head and Neck Surgery, School of Medicine, Louisiana State University Health Shreveport, LA, USA.
Objectives:
To highlight and quantify rural-urban disparities in access to otolaryngology care in Louisiana.
Study Design:
Observational population study.
Methods:
Louisiana parishes (county-equivalents) were categorized by rurality using the National Center for Health Statistics 2023 urban-rural classification. Class levels range from I to VI, with lower class levels corresponding to more urban parishes and higher levels corresponding to more rural parishes. Otolaryngologist data was obtained upon request and fee to the Louisiana State Board of Medical Examiners and freely accessible residency program websites. Population data was obtained from the 2022 U.S. Census postcensal estimates. Travel burden was estimated by mean distance between parish centroid to the closest otolaryngology practice. Provider density was estimated by number of otolaryngologists per 100 000 population. Population-weighted linear regression models were fit using R version 4.5.1 to compare differences in mean distance and mean provider density per parish across NCHS class levels.
Results:
There are 261 otolaryngologists in Louisiana and 91 practice locations. 61% of parishes lack an ENT provider. Overall statistical significance was found (F(3, 60) = 9.10, P < .0001) in comparison of miles to an otolaryngology provider across classes: Class III, 6.55; Class IV, 7.41 (P = .78); Class V, 17.99 (P < .05), Class VI, 29.92 (P < .0001). Overall statistical significance was found (F(3,60) = 4.93, P < .005) in comparison of number of otolaryngologists per 100 000 population across classes: Class III, 7.54; Class IV, 3.27 (P < .05); Class V, 1.67 (P < .05); Class VI, 0.98 (P < .05).
Conclusion:
There is a clear discrepancy in number of ENT providers located in urban and rural parishes, indicating a need to advocate for more evenly distributed resources and providers throughout the state. Additional clinical outreach, like remote outreach clinics, could help expand and more effectively streamline access to specialized otolaryngology care for patients in rural areas.
Related Concept Videos
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
01:11Secondary Healthcare System
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...