Department of Environmental Health and Engineering, The Johns Hopkins University, 3400 N. Charles St. Ames Hall 313, Baltimore, MD, 21218, USA.
Department of Obstetrics & Gynecology, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195-6460, USA.
BMC Health Serv Res. 2022 Jul 19;22(1):928. doi: 10.1186/s12913-022-08281-y.
Many assisted reproductive technology (ART) centers utilize satellite clinics to expand reach and access to clinical services, but their contribution to lowering geographic barriers in access to care has not been examined. This study's purpose is to determine the extent to which satellite clinics impact geographic access to ART and estimate the percentage of reproductive-age women who have geographic access to ART services.
A systematic web-search collected the locations of all main and satellite ART clinics in the United States (US). Driving times were calculated between satellite clinics and main clinics. The percentage of women with geographic access to care was characterized by clinic type using US Census Core Based Statistical Areas (CBSAs). Logistic regression was used to statistically model the presence of main and satellite clinics as a function of CBSA median income and female reproductive-age population.
Four hundred sixty-nine main clinics with embryology labs and 583 satellite clinics were found in the US. Practices with satellite clinics tend to perform more ART cycles. Satellite clinics are located on average 66 minutes from their practice's main clinic and 31 minutes from any main clinic. 22% of satellite clinics were in CBSAs without a main clinic. 46 M (72%) US reproductive-age women live in a CBSA with a main clinic, 5.1 M (8%) women live in a CBSA without a main clinic but at least one satellite clinic, and 13 M (20%) women live in an area with no ART clinic of either type. Female reproductive-age population was found to be a more important predictor of clinic presence than median income.
The majority of satellite clinics in the US are positioned in relative proximity to a main clinic. 85% of satellite clinics are located closer to the main clinic of other practices than to their own main clinic. Less than a quarter of ART satellite clinics expand geographic access to ART services by being located in areas without a main clinic, and the vast majority of practices with satellite clinics position their satellite clinics close to another practice's main clinic.
Not applicable.
许多辅助生殖技术（ART）中心利用卫星诊所来扩大临床服务的范围和可及性，但它们在降低获得护理的地理障碍方面的贡献尚未得到检验。本研究的目的是确定卫星诊所对获得 ART 的地理途径的影响程度，并估计有多少育龄妇女有获得 ART 服务的地理途径。
系统的网络搜索收集了美国所有主要和卫星 ART 诊所的位置。计算了卫星诊所和主要诊所之间的行车时间。使用美国人口普查核心基础统计区（CBSA），根据诊所类型描述了获得护理的妇女的地理比例。使用逻辑回归，根据 CBSA 中位数收入和育龄妇女人口，统计模型中主诊所以及卫星诊所在存在的情况。
在美国发现了 469 家有胚胎学实验室的主要诊所和 583 家卫星诊所。有卫星诊所的诊所往往进行更多的 ART 周期。卫星诊所平均距离其主要诊所 66 分钟，距离任何主要诊所 31 分钟。22%的卫星诊所位于没有主要诊所的 CBSA。4600 万（72%）的美国育龄妇女居住在有主要诊所的 CBSA，510 万（8%）妇女居住在没有主要诊所但至少有一家卫星诊所的 CBSA，1300 万（20%）妇女居住在没有任何类型 ART 诊所的地区。发现女性育龄人口是诊所存在的比中位数收入更重要的预测因素。
美国大多数卫星诊所的位置与主要诊所相对接近。85%的卫星诊所距离其他诊所的主要诊所比自己的主要诊所更近。不到四分之一的 ART 卫星诊所通过位于没有主要诊所的地区来扩大 ART 服务的地理可及性，并且绝大多数有卫星诊所的诊所将其卫星诊所定位在靠近另一家诊所的主要诊所附近。
不适用。
