Topmiller Michael, Walter Grace, Jetty Anuradha, Pristell Crystal, Rankin Jennifer L, Carrozza Mark A, Huffstetler Alison N
The Robert Graham Center for Policy Studies in Family Medicine, American Academy of Family Physicians (AAFP), Washington, DC
The Department of Family Medicine, Georgetown University, Washington, DC.
Ann Fam Med. 2025 Jul 28;23(4):302-307. doi: 10.1370/afm.240073.
Family physicians (FPs) are an important segment of the maternity workforce, particularly in rural areas. This research explores the geographic distribution of family physicians providing maternity care and identifies opportunities for family physicians to expand access to maternity care.
This cross-sectional study used a co-location mapping approach to identify 3 types of counties based on the following: (1) family physicians as the only clinician provider of maternity care along with at least 1 hospital providing obstetric care (FP with Hospital); (2) family physicians as the only clinician provider of maternity care with no hospital providing obstetric care (FP Only); (3) no clinician providers of maternity care but county has at least 1 hospital providing obstetric services (Only Hospital).
Most of the 325 counties across the 3 types are rural and concentrated in the central United States, the upper Midwest, and in Mississippi. More than one-third of these counties are found in just 4 states-Texas, Iowa, Nebraska, and Kansas. Although there are not clear differences in the geographic distribution of FP Only and FP with Hospital counties, Only Hospital counties are located primarily in a few states, including Mississippi, Missouri, Oklahoma, and Texas, and have significantly higher percentages of Black populations.
Our findings demonstrate that while FPs are providing maternity care in rural areas across the United States, opportunities exist to expand their reach, particularly in Mississippi, Texas, and Oklahoma.
家庭医生是产科医疗队伍的重要组成部分,在农村地区尤为如此。本研究探讨了提供产科护理的家庭医生的地理分布,并确定家庭医生扩大产科护理可及性的机会。
这项横断面研究采用了同地映射方法,根据以下标准确定3种类型的县:(1)家庭医生是唯一提供产科护理的临床医生,且至少有1家医院提供产科护理(有医院的家庭医生);(2)家庭医生是唯一提供产科护理的临床医生,且没有医院提供产科护理(仅有家庭医生);(3)没有临床医生提供产科护理,但该县至少有1家医院提供产科服务(仅有医院)。
这3种类型的325个县大多是农村地区,集中在美国中部、中西部上游和密西西比州。其中超过三分之一的县仅分布在4个州——得克萨斯州、爱荷华州、内布拉斯加州和堪萨斯州。虽然仅有家庭医生的县和有医院的家庭医生的县在地理分布上没有明显差异,但仅有医院的县主要位于包括密西西比州、密苏里州、俄克拉何马州和得克萨斯州在内的少数几个州,且黑人人口比例显著更高。
我们的研究结果表明,虽然家庭医生在美国农村地区提供产科护理,但仍有机会扩大他们的服务范围,特别是在密西西比州、得克萨斯州和俄克拉何马州。