725 - Distribution of Pediatric Physical Medicine & Rehabilitation (PM&R) Providers by Neighborhood Area Deprivation Index

The objective of this study was to examine pediatric PM&R access across the United States by looking at the distribution of pediatric PM&R physicians and the neighborhood area deprivation index.

Design: The American Board of Physical Medicine and Rehabilitation (ABPMR) Certified Physician Search was used to compile a list of pediatric PM&R providers (hereafter referred to as “providers”). The National Provider Identifier (NPI) Registry was used to identify the zip code of the providers’ area of practice, and the zip-codes were then matched with their corresponding Area Deprivation Index (ADI) national and state rankings. The ADI was categorized into national quintiles (1 = 1-20, 2 = 21-40, 3 = 41-60, 4 = 61-80, 5 = 81-100) and state deciles (1-10), with lower numbers indicating less deprivation.

Results: The initial search yielded 375 providers; the corresponding ADI was identified for 344 of them (n = 344). Providers were predominantly located in regions with low to moderate deprivation levels, with 76.7% practicing in the 1st, 2nd, and 3rd ADI quintiles (percentile ranges 0-60), 12.8% in the 4th quintile, and 10.5% in the highest deprivation quintile (81-100). Analysis of national ADI reveals a mean of 39.4 and median of 33 (IQR 18-57), and a state decile mean of 4.4 and median of 4 (IQR 2-7). Additionally, the geographic distribution of providers greatly varied, with 9 states having no providers and 5 states having 25 or more providers.

Conclusions: Analysis reveals variation in pediatric PM&R access with a majority of providers practicing in areas of less deprivation. These findings suggest possible barriers to access for children from more deprived neighborhoods. Efforts are needed to ensure adequate access for pediatric patients in all states and should seek to understand and address the factors that may play a role in access.