Mapping Rural-Urban Disparities in Otolaryngology Access: A Statewide Analysis of Georgia's ENT Workforce

While healthcare disparities between rural and urban populations have been documented, access to subspecialty care in rural communities remains poorly characterized. This study aims to quantify rural-urban disparities regarding access to otolaryngologists in Georgia.

Cross-sectional.

Center for Medicare and Medicaid Services (CMS), Georgia Composite Medical Board (GCMB), and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) databases.

The CMS and GCMB databases were used to identify otolaryngologists in Georgia and their primary office location. Residency and fellowship training information was collected through the AAO-HNS database and institutional websites. County-level demographic data were obtained from the 2020 US Census. The 2023 Rural-Urban Continuum Codes were used to classify metropolitan (1-3) and nonmetropolitan (4-9) counties.

A total of 367 otolaryngologists were identified across Georgia's 159 counties (74 metropolitan, 85 nonmetropolitan). Common residency training states included Georgia (20.4%) and New York (6.8%). Overall, 42.5% of otolaryngologists completed fellowship training, with the most common being pediatric otolaryngology (23.7%) and facial plastics (21.8%). Metropolitan counties had an average travel distance of 10.23 miles to the nearest otolaryngologist and 1.91 otolaryngologists per 100,000 residents, compared to 20.32 miles and 0.76 otolaryngologists per 100,000 residents in nonmetropolitan counties (P < .001). Most otolaryngologists (n = 232, 63.2%) were in counties classified as code 1 (most urbanized), which also had the lowest travel burden to the nearest otolaryngologist. Additionally, 12.8% of otolaryngologists practiced in academic settings.

There are significant rural-urban ENT-related disparities in the state of Georgia, with a shortage of otolaryngologists in rural counties.