O2222: Geographic Distance to Pediatric Urologists for Patients Within the United States

Background: Distance to subspecialty care is a known impediment to the delivery of high-quality healthcare. Pediatric urologists are critical to providing specialized genitourinary care. Despite new providers entering the workforce, not all children have equal access to care due to geographic constraints, creating a potential disparity in healthcare. The aim of this study is to describe the variation in geographic proximity to pediatric urologists for pediatric patients using the U.S. Decennial Census.

Methods: A list of board-certified pediatric urologists in 2022, provided by the American Board of Urology, and the 2020 Decennial Census were used to calculate straight-line distance between urologists’ listed zip codes and children’s zip codes. Disparities in distance to care associated with urbanization were analyzed.

Results: A total of 73,103,902 children across the United States and 492 pediatric urologists were included in the analysis, providing a ratio of approximately 148,585 children per pediatric urologist. The average distance to a pediatric urologist was 60.9 miles (range 0-1198.1). The vast majority (84.8%) of children lived within 60 miles of a pediatric urologist , however this left over 11 million children greater than 60 miles from urologic care. On average, Black children lived closer (48.1 miles) to pediatric urologic care than White or Hispanic children (60.2 and 56.8 miles respectively). Over twenty states had an average distance to care of greater than 60 miles with eight states (Alaska, Kansas, Mississippi, Montana, Nebraska, New Mexico, North Dakota, South Dakota) having an average of over 100 miles.

Conclusion: When compared to other specialties such as pediatric surgery, despite the lower number of providers, pediatric urologists have a relatively similar geographic distance to care. The ratio of patients to available providers, like other pediatric surgical specialties, is markedly higher than that seen in adult urology. Disparities in proximity to pediatric urologists were present and persistent across states and geographic regions. Children in rural areas have less access to dedicated urologists based on geographic distance alone. These findings may affect access to diagnostic and therapeutic procedures and are important to developing regionalization strategies to ensure all children have optimal care available to them.