(0238) Otolaryngology Provider Distribution Disparities in Pennsylvania

Introduction: This study aims to investigate the distribution of otolaryngology providers in Pennsylvania compared to the Rural-Urban Commuting Area (RUCA) and state Area Deprivation Index (ADI) census measures.

Methods: In January 2024, a comprehensive list of otolaryngology providers in Pennsylvania and their primary clinic addresses was compiled using the MediFind database. Subsequently, the US Census Geocoder was utilized to extract associated RUCA and ADI measures for provider-associated addresses. The RUCA code assesses population density and commuting flow on a scale from 0 to 10, while the ADI encompasses income, education, employment, and housing factors based on a state-relative decile. Descriptive statistics were performed to determine disparities in otolaryngologist distribution.

Results: Of 563 otolaryngology providers identified in Pennsylvania, 477 (83.7%) had office addresses with available RUCA codes and 446 (79.2%) associated ADI measures. Providers were predominantly located in urban settings, with 466 (93.5%) reporting a primary clinic address in a metropolitan area (RUCA 1-3) and 25 (5.2%) in a micropolitan area (RUCA 3-6). Notably, only 4 (0.8%) providers had primary clinic addresses in small towns (RUCA 7-9) and 2 (0.4%) in rural areas (RUCA 10). Similarly, 171 (38.3%) of providers were located in areas with an ADI in the top two deciles (1-2), while only 56 (12.6%) had clinic addresses in deciles 9-10. The distributions of the Area of Deprivation Index were as follows: 1 (10.3%), 2 (28.0%), 3 (12.1%), 4 (10.5%), 5 (10.1%), 6 (4.3%), 7 (7.8%), 8 (4.3%), 9 (5.4%), and 10 (7.2%). Overall, western and central Pennsylvania exhibited a higher density of low ADI regions and more sparse otolaryngologist access geographically.

Conclusions: Pennsylvania faces disparities in access to otolaryngology providers based on socioeconomic and urban-rural workforce distribution.