FMIGS在美国照顾沙漠

IF 3.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology Pub Date : 2025-10-22 DOI:10.1016/j.jmig.2025.09.021

AB McClurg , ET Carey , I Ninh , KA Schaefer , C Robertson

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引用次数: 0

摘要

研究目的：接受大容量良性妇科外科手术与更好的术后预后相关。AAGL微创妇科外科奖学金（FMIGS）培训复杂良性妇科疾病的高容量外科医生。本研究旨在确定美国FMIGS外科医生有限的地区。设计美国各县FMIGS外科医生分布的横断面地理分析。通过将2001-2024年FMIGS毕业生的人口普查与3108个美国人口普查局县的社会人口统计信息相结合，我们使用数据可视化和回归分析来量化FMIGS服务获取的差异。地理可及性通过(1)每个县每10万居民中FMIGS外科医生的数量，以及(2)每个县中心点到最近的FMIGS外科医生的距离来衡量。我们还研究了访问如何与社会人口变量相关。设置国家县人口普查数据与FMIGS毕业生的国家提供者标识符（npi）重叠。从2001年到2024年，共有626名FMIGS毕业生被确定。干预措施/测量和主要结果fmigs外科医生按最后NPI收费进行绘制。根据获得外科医生的机会对县进行分类：获得充分机会的县（1名FMIGS外科医生），获得有限机会的县（1名FMIGS外科医生）和FMIGS护理沙漠（没有FMIGS外科医生的县）。非西班牙裔黑人（β = 0.055,p < 0.05）和亚裔（β = 1.583,p < 0.01）人口较多的县更有可能获得FMIGS外科医生。非西班牙裔白人（β = -0.045,p < 0.1）和美洲原住民（β = -0.129,p < 0.01）人口较多的县与FMIGS外科手术的就诊次数显著减少相关。此外，较低的受教育程度和较高的贫困率与获得FMIGS服务的机会减少有关。我们确定了626名FMIGS外科医生，为数千万在其一生中需要妇科手术的美国人提供服务。农村县缺乏FMIGS外科医生，这可能严重影响患者的健康结果。

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FMIGS Care Deserts in the United States

Study Objective

Access to high-volume benign gynecologic surgeons is associated with better postoperative outcomes. The AAGL Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS) trains high-volume surgeons in complex benign gynecologic conditions. This study aims to identify regions in the United States (U.S.) with limited access to FMIGS surgeons.

Design

A cross-sectional geographical analysis of the distribution of FMIGS surgeons across U.S. counties. By combining a census of FMIGS graduates from 2001-2024 with socio-demographic information from 3,108 U.S. Census Bureau counites, we used data visualization and regression analysis to quantify disparities in access to FMIGS services. Geographic access is measured by (1) the number of FMIGS surgeons per 100,000 residents per county, and (2) the distance from each county centroid to the nearest FMIGS surgeon. We also examined how access correlates with socio-demographic variables.

Setting

National county census data overlayed with National Provider Identifiers (NPIs) of FMIGS graduates.

Patients or Participants

A total of 626 FMIGS graduates were identified from 2001-2024.

Interventions

N/A

Measurements and Primary Results

FMIGS surgeons were mapped by last NPI charges. Counties were classified by access to surgeons: those with adequate access (>1 FMIGS surgeon), those with limited access (1 FMIGS surgeon), and FMIGS care deserts (counties with no FMIGS surgeon).

Counties with greater non-Hispanic Black (β = 0.055, p < 0.05) and Asian (β = 1.583, p < 0.01 populations were significantly more likely to have access to FMIGS surgeons. Counties with greater of non-Hispanic White (β = -0.045, p < 0.1) and Native American (β = -0.129, p < 0.01) populations were associated with significantly reduced access to FMIGS surgeons. Additionally, lower educational attainment and higher poverty rates correlated with decreased access to FMIGS services.

Conclusion

We identified 626 FMIGS surgeons serving tens of millions of Americans needing gynecological surgery during their lifetimes. Rural counties lack access to FMIGS surgeons, potentially impacting patient health outcomes significantly.

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.