O2155: Geographic Distance to Pediatric Orthopaedic Surgeons for Patients Within the United States

Background: Geographic distance remains a well-recognized barrier to accessing subspecialty healthcare. Pediatric orthopaedic surgeons play a vital role in delivering specialized musculoskeletal care to children. However, despite the continued growth of the pediatric orthopaedic workforce, access to care remains unequal due to geographic constraints, potentially contributing to disparities in health outcomes. This study aimed to more precisely characterize geographic variation in proximity to pediatric orthopaedic surgeons across the United States.

Methods: We utilized the 2022 membership list of the Pediatric Orthopaedic Society of North America (POSNA) and population data from the 2020 U.S. Decennial Census. Straight-line (Euclidean) distances were calculated between the ZIP codes of pediatric orthopaedic surgeons and the zip codes of individuals within the United States. Distances were then analyzed with respect to levels of urbanization and demographic subgroups.

Results: The analysis included 73,103,902 children and 1,198 pediatric orthopaedic surgeons, yielding an average of approximately 61,022 children per surgeon. For comparison, recent studies have reported a ratio of 100,000 adults per 9 adult orthopaedic surgeons. Pediatric orthopaedic surgeons were present in every state except North Dakota and Wyoming. The average distance from a child to the nearest pediatric orthopaedic surgeon was 52.8 miles (range: 0–1199.2 miles). While 87.5% of children lived within 60 miles of a pediatric orthopaedic surgeon, more than 9 million children resided farther than 60 miles from care. On average, Black children lived closer to pediatric orthopaedic care (41.6 miles) than White (55.7 miles) or Hispanic children (49.5 miles). However, a higher percentage of White and Hispanic children lived within 60 miles of care (95.6% and 95.2%, respectively), reflecting the disproportionate impact of rural geography on access.

Conclusion: Significant and persistent disparities in geographic access to pediatric orthopaedic care exist across the United States, particularly affecting children in rural areas. These disparities may limit access to timely diagnostic and therapeutic interventions. Our findings highlight the need for targeted regionalization strategies to ensure equitable access to specialized orthopaedic care for all children, regardless of where they live.