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Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics
Journal article   Open access   Peer reviewed

Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics

Thomas S Gruca, Tae-Hyung Pyo and Gregory C Nelson
Journal of the American Heart Association, Vol.5(7), pp.e002909-002918
06/30/2016
DOI: 10.1161/JAHA.115.002909
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Providing Cardiology Care in Rural Areas Through Visiting Consult1.17 MBDownloadView
Published (Version of record)CC BY-NC V4.0 Open Access
url
https://doi.org/10.1161/JAHA.115.002909View
Published (Version of record)J Am Heart Assoc, 2016; 5(7): e002909 originally published June 30, 2016.

Abstract

<p><p id="x-x-x-p-2"><strong>Background</strong> 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. <p id="x-x-x-p-3"><strong>Methods and Results</strong> 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. <p id="x-x-x-p-4"><strong>Conclusions</strong> 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.</p>
Business Cardiology OAfund access to care geographic variation rural outreach workforce

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