You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making V (PD60)1 Sep 2021PD60-02 18-YEAR POPULATION TRENDS DETERMINE FACTORS ASSOCIATED WITH FUTURE ACCESS TO UROLOGISTS Stephen Pittman, Shachi Patel, Jeffrey Thompson, and Ajay Nangia Stephen PittmanStephen Pittman More articles by this author , Shachi PatelShachi Patel More articles by this author , Jeffrey ThompsonJeffrey Thompson More articles by this author , and Ajay NangiaAjay Nangia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002097.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Concerns are mounting regarding future access to urologic care. Models have projected worsening urologist shortages, however, no studies have accounted for general population migration. Our study evaluated urologist availability by U.S. county since 2000 relative to regional changes in the general population to identify factors that will determine future access to care. METHODS: County level data from 2000, 2010, and 2018 from the Dept. of Health and Human Services (AHRQ), U.S. Census, and American Community Survey were analyzed. 2018 was the most up-to-date AHRQ data available. Availability of urologists by county were determined per 10,000 people aged 20-79. Multiple logistic and geographically-weighted regression were used to identify factors associated with urologist availability and determine regional variability. A predictive model was formulated and a 10-fold cross validation was performed (AUC=0.75). RESULTS: Despite a 6.9% increase in urologists over 18 years, a greater increase in general population resulted in a 13% decrease in local urologist availability (–0.03 urologists/10,000 individuals; 95% CI 0.02-0.04, p <0.0001). Metropolitan and rural counties experienced a 4.5% and 25.4% decrease in urologist availability, respectively. On multiple logistic regression, metropolitan status was the greatest predictor of urologist availability (OR 1.86, 95% CI 1.47-2.35), followed by an increasing number of urologists (OR 1.49, 95% CI 1.16-1.89). The proportion of the population with bachelor’s degrees (OR 1.07, 95% CI 1.06-1.09), unemployment rate (OR 1.13, 95% CI 1.07-1.20), and poverty rate (OR 0.94, 95% CI 0.92-0.97) were also statistically significant predictors. The weight of these factors differed by region, with metropolitan status more significant in the Western U.S., and urologist presence more in the Central U.S. CONCLUSIONS: Urologist availability is decreasing nationwide, however several factors correlate with increasing access by county, including metropolitan status and number of urologists present. The effect of these factors differ by region, thus it will be necessary to uncover regional drivers that are influencing general population migration and urologist concentration to prevent future disparities in care. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1060-e1061 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stephen Pittman More articles by this author Shachi Patel More articles by this author Jeffrey Thompson More articles by this author Ajay Nangia More articles by this author Expand All Advertisement Loading ...