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Member Research & Reports

Member Research & Reports

South Carolina: Researchers Examine Rural-Urban Differences in Access to Thoracic Surgery in the United States

A team of researchers from the epidemiology and biostatistics department and Rural and Minority Health Research Center (University of South Carolina Arnold School of Public Health) has completed a study on rural and urban differences in access to thoracic surgery in the United States. The study was led by associate professor Dr. Jan Eberth and published in The Annals of Thoracic Surgery.

“Because of recent lung cancer screening recommendations and corresponding insurance coverage, it is expected that more early stage cases will be identified that require thoracic surgery,” Dr. Eberth says. “However, these services may not be equally available in all regions.”

With this study, the researchers assessed the availability of thoracic surgeons by geographic variation, rural-urban differences and temporal changes. They looked at this availability both before and after the screening recommendation and insurance policy changes.

Dr. Eberth and her team examined the U.S. thoracic surgery workforce between 2010 and 2014, calculating the density of thoracic surgeons per 100,000 persons. Despite an overall increase in thoracic surgeons during this time period, they observed declining density nationwide (1.5 percent change) and in sparsely populated states. The difference in thoracic surgeon density was most pronounced between small adjacent rural and urban counties, and the Northeast held a disproportionate share of the workforce.

The authors concluded that access to thoracic surgeons in rural areas is a concern. This is due to an older and retiring surgical workforce, the higher burden of lung cancer in rural areas and recent policy change for screening reimbursement.

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