Gaps remain in proximity to pediatric subspecialty care


More doctors have gone into pediatric subspecialties over the past 15 years, which has improved access to necessary care. A new report looks into how much access has changed.

The number of pediatric subspecialists has increased across the United States over the past 15 years. A new report investigates whether the increase has led to better patient proximity.1

Investigators used data from the American Board of Pediatrics (ABP). They looked at the change in the number of subspecialists in 20 pediatric subspecialties between 2003 and 2019. The investigation included 24,375 pediatric subspecialists aged 70 years or younger who had an active certification from the ABP as of June 2019 as well as an address in the United States. The addresses were linked to child population data using zip codes.

Among the 24,735 subspecialists, 23,426 were certified in 1 subspecialty and 939 had certifications for more than 1 subspecialty. Overall the number of certified subspecialists in the United States increased 76.8% between 2003 and 2019. Although the travel distance decreased across all subspecialties, an estimated 1 million to 39 million children lived 80 miles or more away from a subspecialist. An examination of hospital referral regions found increased subspecialist-to-child ratio as well as an increased number of regions that had a subspecialist. A wide variation across regions remains for most specialties, however. Further, 11 subspecialties had 1 or fewer subspecialists per 100,000 children.

The investigators concluded that access to pediatric subspecialty care has improved across the country, but gaps still remain. Considering solutions that encourage movement to underserved areas may be one way to close gaps.


1.    Turner A, Ricketts T, Leslie LK. Comparison of number and geographic distribution of pediatric subspecialists and patient proximity to specialized care in the US between 2003 and 2019. JAMA Pediatr. May 18, 2020. Epub ahead of print. doi: 10.1001/jamapediatrics.2020.1124

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