Factors associated with access to rheumatologists for Medicare patients

Seminars in Arthritis and Rheumatism
Gabriela SchmajukJinoos Yazdany

Abstract

Despite looming rheumatologist shortages and a growing number of patients with arthritis and other rheumatic conditions, nationwide estimates of access to rheumatology care have never been reported. We aimed to measure travel times as a proxy to access to care and to determine the individual and area-level factors associated with long travel times to rheumatologists in the U.S. We used Medicare Part B claims for the 2009 Medicare Chronic Condition Warehouse 5% rheumatoid arthritis/osteoarthritis cohort. Using Google Maps we estimated driving time from the center of a beneficiary's home ZIP code to the center of their rheumatologist's office ZIP code. We examined predictors of travel time ≥90 min in a series of generalized linear mixed models adjusting for rheumatologist supply, rurality, and individual patient characteristics including age, race, gender, and income. We included 41,693 Medicare beneficiaries with 1 or more visits to a rheumatologist in 2009. The median estimated beneficiary travel time to a rheumatologist was 22 min [interquartile range (IQR): 12-40 min]. Overall, 7% of beneficiaries traveled 90 min or longer to visit a rheumatologist. Even after adjusting for covariates, independent predictors of long travel ti...Continue Reading

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Citations

Dec 3, 2016·The Journal of Rheumatology·Claire E H BarberDeborah A Marshall
Jan 9, 2020·Current Opinion in Rheumatology·Day S LennepVikas Majithia
Jun 2, 2018·BioMed Research International·Cătălin CodreanuCorina Mogoşan
Sep 29, 2020·Rheumatic Diseases Clinics of North America·Shilpa Arora, Jinoos Yazdany

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