Estimated Clinician-Patient Ratios in US Orthotic and Prosthetic Care: State-Level Trends and Discrepancies

Abstract

ABSTRACT Introduction For the past 20 years, speculative studies have forewarned of a clinician shortage in the field of orthotics and prosthetics (O&P). Such predictions should emphasize the importance of monitoring potential patient and clinician populations to identify trends and intranational disparities. However, there have been no recent population-based examinations of these previously predicted shortages. Objectives This study estimated geographical differences and evaluated national and state-level trends in O&P care within the United States. The study used data on certified O&P clinicians, state populations, and rates of lower-limb amputation secondary to diabetes in Medicare populations. Study Design The original research article is a retrospective data analysis. Methods Clinician data from the American Board for Certification in Prosthetics Orthotics and Pedorthics, population data from the US Census Bureau, and Medicare data from the Centers for Disease Control and Prevention and the Center for Medicare and Medicaid Services were uploaded into ArcGIS mapping software and geographically weighted for examination across spatial and temporal parameters. Results The data show national and state-level trends and disparities. The findings reveal large differences in care environments between states. Conclusions Speculation on the ability for current supply to meet perceived demand is complicated, but these data update and elaborate upon previous estimations for predicted clinician scarcity in the near future. Further analysis of state-level distance-to-care discrepancies and an examination of which states would benefit most from expansion of O&P services will be necessary. Clinical Relevance Statement This research provides a rudimentary foundation for continued investigation into geographical trends and discrepancies in O&P supply and demand. The successful understanding of these metrics could inform policy and education initiatives, optimize clinical intervention for regional needs, and foster professional expansion into undertreated patient populations.