{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:10:47Z","timestamp":1793146247432,"version":"4.5.0"},"reference-count":13,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4]]},"abstract":"OBJECTIVE<\/jats:title>Absent from an analysis of supply is consideration of the geographic distribution of pediatric neurosurgeons. Several patient socioeconomic metrics are known to be associated with outcome in pediatric neurosurgical diseases, such as hydrocephalus. The purpose of this study was to determine current geographic proximity to pediatric neurosurgical care using professional society databases. This study also sought to establish how socioeconomic factors are related to distance to care, using federal government\u2013collected data.<\/jats:p><\/jats:sec>METHODS<\/jats:title>A list of currently practicing American Board of Pediatric Neurological Surgery (ABPNS)\u2013certified neurosurgeons was compiled (ABPNS group). A separate list of practicing members of the Joint Pediatric Section (JPS) of the American Association of Neurological Surgeons\/Congress of Neurological Surgeons was prepared (JPS group). Current primary practice locations were collected from each professional society database for each ABPNS or JPS neurosurgeon and were charted using ArcGIS mapping software (ESRI, version 10.3) on a United States Census Bureau map. The straight distance from the centroid of each zip code tabulation area (ZCTA) to the nearest neurosurgeon was determined by group type of neurosurgeon (ABPNS vs ABPNS + JPS). ZCTA-level data on demographic and socioeconomic factors were acquired from the American Community Survey, including data in children and young adults (0\u201318 or 0\u201324 years old) and the general population. These data were compared by distance to care and by groups of neurosurgeons (Pearson\u2019s chi-square analysis; the threshold of significance was set at 0.05).<\/jats:p><\/jats:sec>RESULTS<\/jats:title>Three hundred fifty-five practicing neurosurgeons providing pediatric care were located, of whom 215 surgeons were certified by the ABPNS and 140 were JPS members only. The analysis showed that 1 pediatric neurosurgeon is in practice for every 289,799 persons up to the age of 24 years. The average distance between a ZCTA and the nearest pediatric neurosurgeon is 63.3 miles (SE 0.3, range 0.0\u2013499.7 miles). Geographic analysis showed that 27.1% of children live farther than 60 miles from an ABPNS-certified neurosurgeon and 19.7% from either an ABPNS-certified neurosurgeon or a JPS member. ZCTAs with children who live farther than 60 miles from a neurosurgeon providing pediatric care had a marginally higher rate of uninsured children, a higher percentage of families with children living below the federal poverty level, and a higher proportion of persons living in rural areas compared with ZCTAs with children who live within 60 miles of care (p < 0.005 for each finding).<\/jats:p><\/jats:sec>CONCLUSIONS<\/jats:title>The results of this study indicate that there is considerable variation in proximity to pediatric neurosurgical subspecialty care by geographic region. In addition, there is a relationship between distance to neurosurgical care and socioeconomic indicators. Optimization of access to pediatric neurosurgical care may involve strategies to overcome long geographic distances, particularly in rural and underserved areas. Such areas may have disproportionately lower socioeconomic levels, which may further limit access to care and affect outcomes. Both the total number of pediatric neurosurgeons per pediatric population and their geographic distribution could be important in determining appropriate subspecialty supply factors (e.g., the number of accredited pediatric neurosurgical fellowship training programs), as well as being important drivers of neurosurgical patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.9.peds17436","type":"journal-article","created":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T14:55:23Z","timestamp":1516373723000},"page":"434-438","source":"Crossref","is-referenced-by-count":25,"title":["Geographic proximity to specialized pediatric neurosurgical care in the contiguous United States"],"prefix":"10.3171","volume":"21","author":[{"given":"Abdul-Kareem","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Christine","family":"Duhaime","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham & Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Ensuring an Adequate Neurosurgical Workforce for the 21st Century","unstructured":"American Association of Neurological Surgeons, American Board of Neurological Surgery, Congress of Neurological Surgeons, Society of Neurological Surgeons: Ensuring an Adequate Neurosurgical Workforce for the 21st Century. 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