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Factors Surrounding Traveling to Appointments for a Pediatric Orthopaedic Surgeon: Unacceptable Lengths?
Xuyang Song, MD1, Alexandria L Case, BSE2 and Joshua M Abzug, MD2, (1)University of Maryland School of Medicine, Timonium, MD, (2)University of Maryland School of Medicine, Baltimore, MD

Introduction
A major aspect in the delivery of healthcare involves access to specialists, which introduces a number of difficulties for patients and families who are underinsured or live in areas with limited access to specialized healthcare. The purpose of this study is to determine which travel logistics may inhibit access to the availability of specialists.
Materials & Methods
Two hundred pediatric orthopaedic patients seen at an urban/suburban outpatient setting were prospectively surveyed. The survey assessed logistic travel factors to determine the primary reason for selecting our institution. Simple statistics were performed to analyze the data.
Results
43% of patients picked office location as the primary reason for going to a particular outpatient setting while appointment availability was the second most important factor (31%). On average, patients traveled 21 miles (1- 175) and spent 31 minutes each way (3-250). If proximity was their main reason to travel to an office, the average distance to the appointment was 16 miles but when appointment availability was their priority the average increased to 23 miles. 95% of patients traveled by car while the remainder utilized a bus or medical mobility. Among bus riders, an average of 50 minutes to travel only eight miles was needed. Most patients used vacation time to come to an appointment and 25% of families lost wages, at an average cost of $380.
Conclusions
Location is the primary reason why patients choose to see a pediatric orthopaedic surgeon at a particular facility, unless the problem was deemed more acute by the parents, therefore the families were more willing to travel longer distances. Location, travel distance, public transportation, and loss of vacation time or wages present more difficulties to families needing to access specialized healthcare.


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