Access to Care for Children under five in Oklahoma: a Geographic Imputation Application.

M Townsend Cooper, Janis Campbell, Naci Dileki, Paul Darden
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Abstract

Objective: Geographic access to primary care can be a barrier to receiving appropriate preventative services. Oklahoma has been identified as having relatively few primary care providers per capita to care for its population compared to the US. The goal of this analysis was to identify the areas in Oklahoma with significant concentrations of children under five, no pediatrician within reasonable driving distance, and whether other primary care providers are present.

Methods: The 2016 American Community Survey was used to estimate the total population of children under five years of age for each Census Block Group in Oklahoma. Access was defined as a thirty-minute drive time radius computed around each child's imputed location. The National Provider Identifier database was used to identify and locate pediatricians, family medicine physicians, and mid-level providers in Oklahoma. Areas of high concentrations of children with no pediatrician access were identified and non-pediatrician provider locations were superimposed.

Results: Of the estimated 265,818 children under five in Oklahoma, approximately 7% were outside of a thirty-minute drive from a pediatrician. These children are concentrated in northwestern and southeastern Oklahoma, with several smaller additional groupings. There are multiple non-pediatrician primary care providers operating in many of these areas.

Conclusion: There are areas in the state where a paucity of pediatricians and high concentrations of young children lend themselves to collaborations using technology and education to improve the care of children.

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俄克拉何马州五岁以下儿童获得照顾:地理归算应用。
目的:获得初级保健的地理位置可能成为获得适当预防服务的障碍。与美国相比,俄克拉荷马州已被确定为人均初级保健提供者相对较少。本分析的目的是确定俄克拉何马州五岁以下儿童集中的地区,在合理的驾驶距离内没有儿科医生,以及是否存在其他初级保健提供者。方法:使用2016年美国社区调查来估计俄克拉何马州每个人口普查区块组的五岁以下儿童总数。访问被定义为围绕每个孩子的估算位置计算的30分钟车程半径。国家提供者标识数据库用于识别和定位俄克拉何马州的儿科医生、家庭医学医生和中级提供者。确定了没有儿科医生进入的儿童高度集中的地区,并叠加了非儿科医生提供服务的地点。结果:在俄克拉荷马州估计有265,818名5岁以下的儿童中,大约7%的儿童离儿科医生30分钟车程。这些孩子集中在俄克拉荷马州的西北部和东南部,还有几个较小的群体。在这些地区有许多非儿科医生的初级保健提供者。结论:在该州的一些地区,儿科医生的缺乏和幼儿的高度集中使他们能够利用技术和教育合作来改善儿童的护理。
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