Pd40-06 Geographic Changes in Rural Access to Urological Care in the United States

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making III (PD40)1 May 2024PD40-06 GEOGRAPHIC CHANGES IN RURAL ACCESS TO UROLOGICAL CARE IN THE UNITED STATES Kelly Lehner, Garrett Ungerer, Candace Granberg, and Kevin Koo Kelly LehnerKelly Lehner , Garrett UngererGarrett Ungerer , Candace GranbergCandace Granberg , and Kevin KooKevin Koo View All Author Informationhttps://doi.org/10.1097/01.JU.0001009356.04608.d5.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: One-fifth of the U.S. population resides outside urban areas, but unequal access to urological care in rural communities due to workforce shortages and maldistribution can adversely impact patient outcomes. Recent state and federal policies to improve rural access to care include the creation of rural residency training pipelines, loan forgiveness programs for urologists practicing in rural areas, and J-1 visa programs to fill workforce gaps. We aimed to assess whether rural access to urological care has improved by characterizing geographic practice trends in the urologist workforce. METHODS: The AUA Annual Census is the largest annual survey of practicing U.S. urologists. We queried AUA Census data between the years 2014 and 2022 for data on practice location and rurality. Practices located in non-urban areas were categorized as micropolitan (total population 10,000–49,999), small town (pop. 2,500–9,999), or rural (pop. <2,500) based on federal definitions. Census responses were statistically weighted to achieve representativeness for the urologist workforce. We characterized statistical trends using the Mann Kendall test. RESULTS: Between 2014 and 2022, the proportion of U.S. urologists practicing in non-urban areas (population <50,000) demonstrated no statistically significant change (p=0.67) and continues to be less than 10% of the total urology workforce (Figure 1a). There was similarly no change in the micropolitan, small town, or rural workforce. The percentage of early-career urologists (<45 years old) practicing in non-urban areas remained statistically unchanged (p=0.16). States that experienced a decrease in density of urologists per 100,000 of population were typically in the rural South and Mountain West (34.5% average rural population), while states that exhibited increasing urologist density had lower rural population (25.6% rural population) (Figure 1b). The number of U.S. counties with zero practicing urologists ranged between 62.0% and 63.6% during the study period and remained unchanged over time (p=0.76). CONCLUSIONS: Despite increased attention and intervention, the urologist workforce in non-urban areas remains unchanged over the past decade. Pipeline training programs and legislative policy solutions are urgently needed to ensure rural access to care. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e821 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kelly Lehner More articles by this author Garrett Ungerer More articles by this author Candace Granberg More articles by this author Kevin Koo More articles by this author Expand All Advertisement PDF downloadLoading ...