Accessibility of Obstetrician–Gynecologists and Gynecologic Oncologists to the Medicare Population: A State-By-State Analysis [A296

Abstract

INTRODUCTION: Access to care is a predictor of health outcomes for the aged female population. The purpose of this study was to evaluate the accessibility of obstetrician–gynecologists (ob-gyns) and gynecologic oncologists to the U.S. Medicare population, over time and by state. METHODS: The supply of ob-gyns and gynecologic oncologists was extracted from the Physician and Other Supplier Public Use File (POSPUF) database of Medicare Part B claims submitted to the U.S. Centers for Medicare and Medicaid Services. This supply was compared to the number of providers normalized by the number of Original Medicare beneficiaries; values reported are providers per 100,000 beneficiaries by state from 2012 to 2019, obtained from the Kaiser Family Foundation. RESULTS: In 2019, the average number of ob-gyns per 100,000 beneficiaries across all states was 67.2 (standard deviation [SD] ±19.3), and ranged from 157.01 (District of Columbia) to 45.39 (Wyoming). The average number of gynecologic oncologists was 2.48 (SD±1.18), and ranged from 6.60 (District of Columbia) to 0.83 (Mississippi). From 2012 to 2019, the average absolute difference in number of ob-gyns across all states was −7.71±8.59 and ranged from+15.74 (Connecticut) to −37.32 (Alaska). For gynecologic oncologists, this difference was+0.10±1.04 and ranged from+5.22 (District of Columbia) to −1.84 (South Dakota). CONCLUSION: There is wide geographic variation in the accessibility and growth rate of ob-gyns and GYNONCs for the Medicare population. This provides insight into areas of the country where the supply of ob-gyns and gynecologic oncologists may not meet current and future demand.