LAUSR

PURPOSE To assess the number of infants at risk of delayed primary congenital glaucoma (PCG) evaluation due to long travel times to specialists. DESIGN Cross-sectional geospatial service coverage analysis. METHODS All American Glaucoma Society (AGS) and American Association for Pediatric Ophthalmology and Strabismus (AAPOS) provider locations were geocoded using each organization's member directory. Sixty-minute drive time regions to providers were generated using ArcGIS Pro (Esri, Redlands, CA). The geographic intersection of AGS and AAPOS service areas was computed because patients typically require visits to both types of specialists. American Community Survey data was then overlaid to estimate the number of infants within and beyond the AGS/AAPOS service areas. RESULTS One thousand twenty-nine AGS and 1,040 AAPOS provider locations were geocoded. The analysis yielded 944,047 infants age 0-1 year (23.6%) who live beyond the AGS/AAPOS service areas. Therefore, approximately 14 to 94 new PCG cases/year may be at risk of delayed diagnosis due to living in a potential service desert. Compared to children living within the AGS/AAPOS service areas, children under age 6 years in these potential service deserts were more likely to live in households earning below the US federal poverty level, lack health insurance, and live in a single parent home. These communities are disproportionately likely to experience other rural health disparities, and are more prevalent across the Great Plains. CONCLUSION Service coverage analysis is a useful tool for identifying underserved regions for PCG referrals and evaluation. These data may assist in targeting screening programs in low access areas for pediatric glaucoma care.