Abstract Details

Title Geographic Distribution of Neurologists in Rural Areas

Topic Health Care Disparities

Presentation(s) S28 - Health Care Disparities (2:24 PM-2:36 PM)

Poster/Presentation
Number 008

Background Rural America has faced healthcare disparities and an increase in mortality since the 1980s compared to urban areas. Disparities are more pronounced in specialty care, including neurology, as reflected in regional differences in stroke outcomes (23% higher mortality in large rural areas, 30% higher mortality in most rural areas, compared to urban). An accurate estimate of the geographic distribution of neurology providers is needed to clarify the causes of disparity and identify regions most in need of additional coverage.

Objective

To assess the distribution of neurology providers in rural areas of the US.

Design/Methods The geographic distribution of neurologists and neurology physician extenders in September 2021 was examined using National Plan and Provider Enumeration System National Provider Identifier (NPI) data. The NPI database was reviewed for all fifty states and the numbers of neurology providers tallied for all rural-designated counties according to US 2010 Census data according to primary practice location listed.

Results 24,658 providers were listed in the NPI registry across the fifty states using “neurology” as the primary search term for individual taxonomy. The vast majority of these were physicians, and minority physician extenders (Physician Assistants and Certified Registered Nurse Practitioners). Chiropractor-neurology and physical therapy-neurology taxonomies introduced some uncertainty. A total of 776 neurologists (3.1%) were identified with primary practice location in a rural county. Out of the total 2,014 rural counties across the country, only 337 had at least one neurologist (20%). Distribution varied by census division, with the highest rural neurologist/rural county ratio in New England (150%) and the lowest in the West South Central (16%).

Conclusions Although 15-20% of the US population is classified as rural, only 3.1% of neurologists practice in primarily rural locales. Additionally, neurologists are unevenly distributed across the rural parts of the country. This disparity may contribute to outcome disparity in neurological disease.

Authors/Disclosures
Micaela R. Owens, DO (Marshall University) PRESENTER	Dr. Owens has nothing to disclose.
	No disclosure on file
Christopher J. Whiting, DO	Dr. Whiting has nothing to disclose.