Distance to care and relative supply among pediatric surgical subspecialties

Mayer, Michelle L.; Beil, Heather; Allmen, Daniel von

doi:10.1016/j.jpedsurg.2008.08.015

Cited by 68 publications

(43 citation statements)

References 32 publications

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“…However, the differences in supply were not associated with meaningful differences in child or family disease burden. There are geographic inequalities in the distribution of pediatric subspecialists in the United States [1][2][3][4][5] and Canada. 6 In the United States, 10% to 30% of children must travel .80 miles to access many pediatric subspecialists, including endocrinology, pulmonary, gastroenterology, nephrology, and developmental pediatrics.…”

Section: Discussionmentioning

confidence: 99%

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Supply and Utilization of Pediatric Subspecialists in the United States

et al. 2014

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Section: Discussionmentioning

confidence: 99%

“…7 One-quarter of children live .1 hour from the closest pediatric surgical subspecialist. 4 Pediatric subspecialty care is more limited in communities that are rural, poor, or in Western mountain states. 3 Increased training has not improved the maldistribution across the United States.…”

Section: Discussionmentioning

confidence: 99%

Supply and Utilization of Pediatric Subspecialists in the United States

et al. 2014

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“…A recent analysis showed that of the 3107 counties in the US, only 216 (7%) have coverage by a pediatric general surgeon [28]. Many children must travel long distances to receive care from a pediatric surgeon [29]. General surgeons often care for children who need surgical care; however, the workforce issues facing general surgeons are even more daunting.…”

Section: Discussionmentioning

confidence: 99%

The ACGME case log: General surgery resident experience in pediatric surgery

Gow

Drake

Aarabi

et al. 2013

Journal of Pediatric Surgery

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Background General surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time. Methods The ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989–1990 to 2010–2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989–90 to AY1993–94), Period II (AY1994–95 to AY1998–99), Period III (AY1999–00 to AY2002–03), Period IV (AY2003–04 to AY2006–07), and Period V (AY2007–08 to AY2010–11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P < .05. Results Overall GS case load remained relatively stable. Of total cases, PS cases accounted for 5.4% in Period I and 3.7% in Period V. Designated pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time. Conclusions GS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended.

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“…25) [64]. In developing countries, the ratio of practicing pediatric surgeons to population size is alarmingly small.…”

Section: The Global Perspectivementioning

confidence: 99%