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Access to Pulmonologists for Adults with COPD

Chest; ePub 2016 May 26; Croft, Lu, et al

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Primary care physicians (PCPs) are likely to care for an increasing number of adults with chronic obstructive pulmonary disease (COPD) due to limited county-level access to pulmonologists, a recent study suggests. The study identified 12,392 service locations of practicing pulmonologists and 248,000 PCPs from the 2013 National Provider Identifier Registry and model-based county-level population counts of US adults aged >18 years with COPD were estimated. Researchers found:

• The majority of US adults had geographic access to a PCP within a 10-mile buffer distance and almost all had access to a PCP within 50 miles.

• At least 1 pulmonologist within 10 miles was available for 97.5% of US adults living in urbanized areas, but only for 38.3% in urban clusters and 34.5% in rural areas.

• When distance increased to 50 miles, at least 1 pulmonologist was available for 100% in urbanized areas, 93.2% in urban clusters, and 95.2% in rural areas.

• County-level ratios of adults with COPD per pulmonologist varied greatly across the US.

Citation: Croft JB, Lu H, Zhang X, Holt JB. Geographic accessibility of pulmonologists for adults with chronic obstructive pulmonary disease: United States, 2013. [Published online ahead of print May 26, 2016]. Chest. doi:10.1016/j.chest.2016.05.014.

Commentary: While the US is predominantly urban, approximately one third of the US population lives in either rural areas or urban clusters, which are defined as areas with at least 2,500 and less than 50,000 people.1 COPD is common, with over 15 million Americans diagnosed with COPD and half of people with COPD undiagnosed. In addition, it is the third leading cause of death in the US, and the only one of the top five causes of death with an increasing incidence of disease.2 This data emphasizes the importance of primary care in the management of respiratory disease. Primary care physicians are and will remain an important source of care for patients with COPD, and in many areas of the country, the only source of care for patients with COPD. —Neil Skolnik, MD

1. United States Census Bureau. 2010 Census Urban and Rural Classification and Urban Area Criteria. https://www.census.gov/geo/reference/ua/urban-rural-2010.html. Accessed June 13, 2016.

2. Hoyert DL, Xu JQ. Deaths: preliminary data for 2011. Natl Vital Stat Rep. 2012;61(6):1-65. Hyattsville, MD: National Center for Health Statistics, 2012.

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