Kristin M Sommerhalter1, Tabassum Z Insaf1,2, Tugba Akkaya-Hocagil1,2, Claire E McGarry1, Sherry L Farr3, Karrie F Downing3,4, George K Lui5, Ali N Zaidi6,7, Alissa R Van Zutphen1,2. 1. New York State Department of Health, Albany, New York. 2. Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York. 3. U.S. Centers for Disease Control and Prevention, Atlanta, Georgia. 4. Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee. 5. Divisions of Cardiovascular Medicine and Pediatric Cardiology, Stanford School of Medicine, Stanford, California. 6. Children's Hospital at Montefiore, Bronx, New York. 7. Albert Einstein College of Medicine, Bronx, New York.
Abstract
BACKGROUND: Many individuals with congenital heart defects (CHDs) discontinue cardiac care in adolescence, putting them at risk of adverse health outcomes. Because geographic barriers may contribute to cessation of care, we sought to characterize geographic access to comprehensive cardiac care among adolescents with CHDs. METHODS: Using a population-based, 11-county surveillance system of CHDs in New York, we characterized proximity to the nearest pediatric cardiac surgical care center among adolescents aged 11 to 19 years with CHDs. Residential addresses were extracted from surveillance records documenting 2008 to 2010 healthcare encounters. Addresses were geocoded using ArcGIS and the New York State Street and Address Maintenance Program, a statewide address point database. One-way drive and public transit time from residence to nearest center were calculated using R packages gmapsdistance and rgeos with the Google Maps Distance Matrix application programming interface. A marginal model was constructed to identify predictors associated with one-way travel time. RESULTS: We identified 2522 adolescents with 3058 corresponding residential addresses and 12 pediatric cardiac surgical care centers. The median drive time from residence to nearest center was 18.3 min, and drive time was 30 min or less for 2475 (80.9%) addresses. Predicted drive time was longest for rural western addresses in high poverty census tracts (68.7 min). Public transit was available for most residences in urban areas but for few in rural areas. CONCLUSION: We identified areas with geographic barriers to surgical care. Future research is needed to determine how these barriers influence continuity of care among adolescents with CHDs. Birth Defects Research 109:1494-1503, 2017.
BACKGROUND: Many individuals with congenital heart defects (CHDs) discontinue cardiac care in adolescence, putting them at risk of adverse health outcomes. Because geographic barriers may contribute to cessation of care, we sought to characterize geographic access to comprehensive cardiac care among adolescents with CHDs. METHODS: Using a population-based, 11-county surveillance system of CHDs in New York, we characterized proximity to the nearest pediatric cardiac surgical care center among adolescents aged 11 to 19 years with CHDs. Residential addresses were extracted from surveillance records documenting 2008 to 2010 healthcare encounters. Addresses were geocoded using ArcGIS and the New York State Street and Address Maintenance Program, a statewide address point database. One-way drive and public transit time from residence to nearest center were calculated using R packages gmapsdistance and rgeos with the Google Maps Distance Matrix application programming interface. A marginal model was constructed to identify predictors associated with one-way travel time. RESULTS: We identified 2522 adolescents with 3058 corresponding residential addresses and 12 pediatric cardiac surgical care centers. The median drive time from residence to nearest center was 18.3 min, and drive time was 30 min or less for 2475 (80.9%) addresses. Predicted drive time was longest for rural western addresses in high poverty census tracts (68.7 min). Public transit was available for most residences in urban areas but for few in rural areas. CONCLUSION: We identified areas with geographic barriers to surgical care. Future research is needed to determine how these barriers influence continuity of care among adolescents with CHDs. Birth Defects Research 109:1494-1503, 2017.
Authors: E Foster; T P Graham; D J Driscoll; G J Reid; J G Reiss; I A Russell; M Sermer; S C Siu; K Uzark; R G Williams; G D Webb Journal: J Am Coll Cardiol Date: 2001-04 Impact factor: 24.094
Authors: Eric M Delmelle; Cynthia H Cassell; Coline Dony; Elizabeth Radcliff; Jean Paul Tanner; Csaba Siffel; Russell S Kirby Journal: Birth Defects Res A Clin Mol Teratol Date: 2013-09-02
Authors: Vaughn R A Call; Lance D Erickson; Nancy K Dailey; Bret L Hicken; Randall Rupper; Jeremy B Yorgason; Byron Bair Journal: Telemed J E Health Date: 2015-04-03 Impact factor: 3.536
Authors: Michelle Z Gurvitz; Ruey-Kang Chang; Fernando J Ramos; Vivekanand Allada; John S Child; Thomas S Klitzner Journal: J Am Coll Cardiol Date: 2005-09-06 Impact factor: 24.094
Authors: Amy P Case; Mark A Canfield; Ann Barnett; Patricia Raimondo; Margaret Drummond-Borg; Judith Livingston; Jenifer Kowalik Journal: Birth Defects Res A Clin Mol Teratol Date: 2008-11
Authors: Jeffrey P Jacobs; Constantine Mavroudis; James A Quintessenza; Paul J Chai; Sara K Pasquali; Kevin D Hill; Luca A Vricella; Marshall L Jacobs; Joseph A Dearani; Duke Cameron Journal: Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu Date: 2014
Authors: Sherry L Farr; Catharine Riley; Alissa R Van Zutphen; Timothy J Brei; Vinita Oberoi Leedom; Russell S Kirby; Laura J Pabst Journal: Birth Defects Res Date: 2021-12-18 Impact factor: 2.661
Authors: Monica K Lieng; James P Marcin; Ilana S Sigal; Sarah C Haynes; Parul Dayal; Daniel J Tancredi; Marianne Gausche-Hill; Jamie L Mouzoon; Patrick S Romano; Jennifer L Rosenthal Journal: J Rural Health Date: 2021-03-18 Impact factor: 4.333
Authors: Wan-Hsiang Hsu; Kristin M Sommerhalter; Claire E McGarry; Sherry L Farr; Karrie F Downing; George K Lui; Ali N Zaidi; Daphne T Hsu; Alissa R Van Zutphen Journal: Birth Defects Res Date: 2020-09-29 Impact factor: 2.661
Authors: Tabassum Z Insaf; Kristin M Sommerhalter; Treeva A Jaff; Sherry L Farr; Karrie F Downing; Ali N Zaidi; George K Lui; Alissa R Van Zutphen Journal: Am Heart J Date: 2021-02-23 Impact factor: 5.099