Geospatial Accessibility to Pediatric Resources according to Child Opportunity, Race/Ethnic Composition and Urbanicity.

IF 3 3区医学 Q1 PEDIATRICS Academic Pediatrics Pub Date : 2025-03-13 DOI:10.1016/j.acap.2025.102817

E M Bucholz, R Thomas Day, R Khazanchi, F Alizadeh, J Blossom, D Bailey, S Worthington, J J Liu, R Thiagarajan Mbbs, V L Ward, K M Moynihan

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引用次数: 0

Abstract

Objectives: We analyze drive times to pediatric inpatient and intensive care services in the U.S. according to Child Opportunity Index (COI), racial/ethnic composition, and urbanicity.

Study design: Geospatial information system analyses delineated drive-time catchments of 0-30, 31-60, 61-120 and 120-240minutes around hospitals with ≥5 inpatient pediatric and pediatric intensive care unit(PICU) beds. For each catchment, population-weighted COI, percent pediatric population of underrepresented races/ethnicities (%UR), and urbanicity were calculated and compared between the four drive-time catchments and for >60 versus ≤60-minute drive-times. Prevalence ratios (PR) were calculated for >60 versus ≤60-minute drive-times to compare the prevalence of longer drive-times for catchments with lower COI and lower %UR (versus higher), and rural versus urban areas.

Results: Overall, 8.1% and 20.5% of children reside >60-minutes from pediatric and PICU services. Catchments within 60-minutes of inpatient or PICU services had higher COI (4.8, [95%CI 3.2, 6.5] and 6.1 [7.7, 4.5] respectively) compared with those >60-minutes. Very low quintile COI catchments (versus very high) were more likely to be >60-minutes from pediatric inpatient care (PR 2.89 [2.30, 3.61]) and PICU (PR 2.48 [1.92, 3.20]). %UR was 2.7% higher in <60-minute drive-time catchments (95%CI 0.1, 5.23, p=0.043) versus those >60-minutes. Greater prevalence of >60-minute drive-times was seen in catchments with a lower %UR (versus higher) and for rural (versus urban) catchments for pediatric and PICU services.

Conclusions: Children living further from pediatric care tend to have less resources and reside in rural areas. These data inform public health solutions for equitable resource distribution as care consolidates.

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.