Document Type

Article

Peer Reviewed

1

Publication Date

6-30-2016

Journal/Book/Conference Title

Journal of the American Heart Association

DOI of Published Version

10.1161/JAHA.115.002909

Total Pages

10

Abstract

Background Workforce experts predict a future shortage of cardiologists that is expected to impact rural areas more severely than urban areas. However, there is little research on how rural patients are currently served through clinical outreach. This study examines the impact of cardiology outreach in Iowa, a state with a large rural population, on participating cardiologists and on patient access.

Methods and Results Outreach clinics are tracked annually in the Office of Statewide Clinical Education Programs Visiting Medical Consultant Database (University of Iowa Carver College of Medicine). Data from 2014 were analyzed. In 2014, an estimated 5460 visiting consultant clinic days were provided in 96 predominantly rural cities by 167 cardiologists from Iowa and adjoining states. Forty‐five percent of Iowa cardiologists participated in rural outreach. Visiting cardiologists from Iowa and adjoining states drive an estimated 45 000 miles per month. Because of monthly outreach clinics, the average driving time to the nearest cardiologist falls from 42.2±20.0 to 14.7±11.0 minutes for rural Iowans. Cardiology outreach improves geographic access to office‐based cardiology care for more than 1 million Iowans out of a total population of 3 million. Direct travel costs and opportunity costs associated with physician travel are estimated to be more than $2.1 million per year.

Conclusions Cardiologists in Iowa and adjoining states have expanded access to office‐based cardiology care from 18 to 89 of the 99 counties in Iowa. In these 71 counties without a full‐time cardiologist, visiting consultant clinics can accommodate more than 50% of office visits in the patients’ home county.

Keywords

OAfund, access to care, cardiology, geographic variation, rural outreach, workforce

Journal Article Version

Version of Record

Published Article/Book Citation

J Am Heart Assoc. 2016; 5: e002909 originally published June 30, 2016 doi: 10.1161/JAHA.115.002909

Rights

© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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URL

http://ir.uiowa.edu/tippie_pubs/68