1Department of Neurosurgery, Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois; and.
2Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona.
J Neurosurg. 2023 Jul 7;140(1):282-290. doi: 10.3171/2023.5.JNS23203. Print 2024 Jan 1.
Women neurosurgeons (WNs) continue to remain a minority in the specialty despite significant initiatives to increase their representation. One domain less explored is the regional distribution of WNs, facilitated by the hiring practices of neurosurgical departments across the US. In this analysis, the authors coupled the stated practice location of WNs with regional geospatial data to identify hot spots and cold spots of prevalence and examined regional predictors of increases and decreases in WNs over time.
The authors examined the National Provider Identifier (NPI) numbers of all neurosurgeons obtained via the National Plan and Provider Enumeration System (NPPES), identifying the percentage of WNs in each county for which data were appended with data from the US Census Bureau. Change in WN rates was identified by calculating a regression slope for all years included (2015-2022). Hot spots and cold spots of WNs were identified through Moran's clustering analysis. Population and surgeon features were compared for hot spots and cold spots.
WNs constituted 10.73% of all currently active neurosurgical NPIs, which has increased from 2015 (8.81%). Three hot spots were found-including the Middle Atlantic and Pacific divisions-that contrasted with scattered cold spots throughout the East Central regions that included Memphis as a major city. Although relatively rapidly growing, hot spots had significant gender inequality, with a median WN percentage of 11.38% and a median of 0.61 WNs added to each respective county per year.
The authors analyzed the prevalence of WNs by using aggregated data from the NPPES and US Census Bureau. The authors also show regional hot spots of WNs and that the establishment of WNs in a region is a predictor of additional WNs entering the region. These data suggest that female neurosurgical mentorship and representation may be a major driver of acceptance and further gender diversity in a given region.
尽管采取了多项措施来增加女性神经外科医生（WNs）的数量，但她们在该领域的比例仍然较低。一个较少被探索的领域是 WNs 的区域分布，这得益于美国神经外科部门的招聘实践。在这项分析中，作者将 WNs 的申报执业地点与区域地理空间数据相结合，以确定患病率的热点和冷点，并研究了随着时间的推移 WNs 数量增加和减少的区域预测因素。
作者通过国家计划和提供者枚举系统（NPPES）检查了所有通过国家提供者标识符（NPI）获得的神经外科医生的 NPI 号码，确定了每个县的 WNs 百分比，其中数据通过美国人口普查局的数据进行了补充。通过计算所有包含年份的回归斜率（2015-2022 年）来确定 WN 率的变化。通过 Moran 聚类分析确定 WNs 的热点和冷点。对热点和冷点进行了人口和外科医生特征比较。
WNs 占所有当前活跃的神经外科 NPI 的 10.73%，比 2015 年（8.81%）有所增加。发现了三个热点，包括大西洋中部和太平洋分部，与东中部地区的分散冷点形成对比，其中孟菲斯是一个主要城市。尽管增长较快，但热点地区仍存在显著的性别不平等，WN 比例中位数为 11.38%，每个县每年增加 0.61 名 WN。
作者使用 NPPES 和美国人口普查局的汇总数据分析了 WNs 的患病率。作者还展示了 WNs 的区域热点，并且一个区域内 WNs 的建立是该区域内新增 WNs 的预测因素。这些数据表明，女性神经外科医生的指导和代表性可能是一个地区接受度和进一步性别多样性的主要驱动因素。
