Distance to nearest cardiologist larger in western US, especially for subspecialist care
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Key takeaways:
- Proximity to a cardiologist was significantly lower for residents in the eastern U.S. vs. the western U.S.
- Some patients would travel more than 100 km to visit a heart failure specialist.
Many U.S. residents live less than 20 km from a cardiologist, but distances in the western U.S. were larger, with some patients traveling more than 100 km to see an HF physician, researchers wrote.
Issam Motairek, MD, research associate in the division of cardiovascular medicine at Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, and colleagues used data from the CMS National Plan and Provider Enumeration System and the U.S. Census Bureau to quantify residents’ geographic distance to their nearest cardiologists.
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Their findings were published in Circulation: Cardiovascular Quality and Outcomes.
The researchers first identified all cardiologists in the U.S., defined based on taxonomy numbers for CVDs, interventional cardiology, advanced HF and transplant cardiology and clinical cardiac electrophysiology, according to the study.
Cardiologists were then geocoded and the researchers calculated the median distance between the centroid of each U.S. census block to that of its nearest cardiologist, weighted by the 2020 census block population and stratified by urban or rural areas.
Motairek and colleagues identified 47,225 cardiologists in the U.S, including 9,594 interventional cardiologists, 4,328 cardiac electrophysiologists and 973 HF physicians.
The overall median distance to the closest cardiologist in the U.S. was 2.84 km, with 85.2% of residents living within 20 km of one; however, median distance was smaller in the eastern U.S. compared with western U.S., according to the study.
Interventional cardiologists had the shortest median distance of 5.06 km, followed by 7.35 km for cardiac electrophysiologists and 16.46 km for HF physicians.
In many areas of the U.S., patients requiring care from HF cardiologists often traveled more than 100 km, except for those living in urban areas, according to the study.
Motairek and colleagues noted that in contrast, the median distance to a primary care provider was 0.81 km and 98.5% of residents lived within a 20 km radius of an internal medicine and/or family medicine physician, with minimal variation between urban and rural areas.
Across the U.S., Asian residents had the shortest distance to cardiologists, followed by Black, Hispanic, white and Hawaiian residents. Native Americans had the longest distance, according to the study.
“Longer distances to cardiologists can reduce the likelihood of seeking a medical consultation at symptom onset, lead to less adherence to follow-up visits, and result in therapeutic inertia in serious conditions,” the researchers wrote. “Geographic proximity does not necessarily imply access. While proximity can improve access, social and financial barriers may hinder it.”
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