Inequalities in Specialist Hand Surgeon Distribution across the United States

Abstract

Specialist hand surgeons are distributed unevenly across the United States. State-level analyses suggest that states with lower per capita incomes may be particularly underserved, which may contribute to regional disparities in access to emergency hand trauma care.

Acute Treatment Patterns for Lower Extremity Trauma in the United States: Flaps versus Amputation

“…Geographic, age, and racial disparities have been demonstrated in rates and method of postmastectomy breast reconstruction, [18][19][20][21] and racial disparities have been captured in the treatment of patients with craniosynostosis. 22 Similar patterns of inequalities based on demographic or geographic differences have also been demonstrated with regard to hand surgery, 23,24 access to orthopaedic care, 25,26 and upper extremity replantation surgery, 27 which shares many of the high-resource needs of limb salvage.…”

Regional Maldistribution of China’s Hospitals Based on Their Structural System

“…Compared with the previous studies, this study mainly makes a progress in the following three aspects: (1) The previous studies mainly focus on the regional distribution of a certain kind of healthcare resources as a whole, including the studies on regional distribution of medical institutions [35,36], medical expenses [8], physicians [41][42][43], and medical beds [38][39][40]. However, few studies analyze a certain kind of healthcare resources based on the structural systems themselves deeply.…”

“…Existing researches mostly explore RMH or relevant areas from four aspects. (1) Measuring RMH: Many studies quantify RMH through per capita or per land beds or physicians [38][39][40][41][42][43]. (2) Looking for the influencing factors and determinants of regional healthcare resource distribution: Economics [12,18], society [11], institution [19,21], and location [14], which all play significant roles in regional healthcare resource distribution.…”

“…This study chooses per capita hospitals in each region based on the following reasons: (1) Most previous studies focus on specific healthcare resources of hospitals, such as beds [38][39][40] or physicians [41][42][43], rather than the whole hospital institutions. This study aims to make up the previous gap to explore regional maldistribution of the whole hospitals based on the China's unique hospital structural system so that we focus on the whole hospitals but not one resource of hospitals.…”

“…Thereafter, it is widely used to study inequalities in various fields, such as macro-economy [3,52], environment [53,54], health [11,35,36,41,55], transportation [56], education [10,57] and others. Compared with other common measure indexes that are applied to measure inequality, such as Theil index, Coefficient of Variation, and Centration Index, Gini Coefficient has a wider application [58].…”