Access to Neurologic Care Is Worse Among These Populations in the US

Rural locations, areas with higher proportions of Hispanic individuals, and individuals with disabilities have worse access to neurologic care in the United States, according to study results presented at the 2023 American Academy of Neurology (AAN) Annual Meeting, held from April 22 to 27, 2023, in Boston, Massachusetts.

Researchers looked at neurologic practice locations from 2022 CMS Care Compare physician data and computed spatial access to neurologic care measures for US census tracts. They evaluated tract-level characteristics, including sex, age, race, ethnicity, education, income, insurance, percentage with a computer, percentage without a vehicle, percentage with limited English, and percentage with hearing, vision, cognitive, and ambulatory difficulties using data from 2020 American Community Survey 5-year estimates. The researchers also determined whether the areas were rural or urban, which they obtained from commuting area code data.

They built generalized additive models using 60-mile enhanced 2-step floating catchment area spatial access ratios and 3-step floating catchment area spatial access ratios to serve as predictors for outcomes and community characteristics.

Access to neurologic care was defined as a percentage change in the ratio of neurologists to individuals.

Based on their evaluation of 73,057 US census tracts, the researchers found that access was almost 81% lower for rural areas and 61% lower for metropolitan areas. They also found that tracts with a higher percentage of Hispanic populations, men, public insurance, uninsured, and individuals with hearing, vision, or ambulatory difficulties had lower access to neurologic care. Urban census tracts and tracts with greater Black and older populations were more likely to have higher spatial access.

The researchers concluded, “To improve neurological care disparities, future interventions will need to target unique access drivers for specific populations.”