Geographic access to care and pediatric surgical outcomes.
Am J Surg
; 225(5): 903-908, 2023 05.
Article
em En
| MEDLINE
| ID: mdl-36803619
ABSTRACT
INTRODUCTION:
Rurality and distance traveled for healthcare are associated with worse pediatric health indicators.METHODS:
We retrospectively analyzed patients ages 0-21 at a quaternary pediatric surgical facility with a large rural catchment area between 1/1/2016-12/31/2020. Patient addresses were designated as metropolitan or non-metropolitan. 60- and 120-min driving rings from our institution were calculated. Logistic regression assessed the effect of rurality and distance traveled for care on postoperative mortality and serious adverse events (SAE).RESULTS:
Among 56,655 patients, 84.3% were from metropolitan areas, 8.4% from non-metropolitan areas, and 7.3% could not be geocoded. 64% were within 60-min driving and 80% within 120-min. On univariable regression, patients living >120-min experienced 59% (95% CI 1.09, 2.30) increased odds of mortality and 97% (95% CI 1.84, 2.12) increased odds of SAE compared to those <60-min. Non-metropolitan patients experienced 38% (95% CI 1.26, 1.52) increased odds of a serious postoperative event compared to metropolitan patients.DISCUSSION:
Efforts to improve geographic access to pediatric care are needed to mitigate the impact of rurality and travel time on inequitable surgical outcomes.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Viagem
/
Acessibilidade aos Serviços de Saúde
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article