The distribution of infectious disease (ID) physicians in the United States is geographically skewed, with 90 percent of U.S. counties having below-average ID physician density or no ID physicians at all, according to a research letter published online June 3 in the Annals of Internal Medicine.
Rochelle P. Walensky, M.D., from Massachusetts General Hospital in Boston, and colleagues examined the distribution of ID specialists compared to the needs of the COVID-19 pandemic across the United States. The 2017 Medicare Provider Utilization and Payment Data were used to identify county-level ID physician densities (the number of ID physicians per 100,000 persons).
The researchers found that in 2017, the national average density was 1.76 ID physicians per 100,000 persons, but the distribution was geographically skewed. Of the 3,142 U.S. counties, 10.5 percent had above-average ID physician densities, 9.9 percent had below-average ID physician densities, and 79.5 percent of counties did not have a single ID physician. Among the 785 counties with the highest quartile of COVID-19 disease burden, 18.7 percent had above-average ID physician densities, 14.9 percent had below-average ID physician densities, and 66.4 percent had no ID physician coverage. Among counties with the lowest COVID-19 burden, nearly 95 percent did not have a single ID physician.
“Data demonstrating the association between ID physician care and COVID-19 clinical outcomes have yet to emerge,” the authors write. “However, for many other infectious diseases, a robust evidence base supports the association between ID physician intervention and improved outcomes.”