The following is a summary of “Supply of obstetrician–gynecologists and gynecologic oncologists to the US Medicare population: a state-by-state analysis,” published in the February 2023 issue of Obstetrics and Gynecology by Talbott, et al.

In the United States, the availability of gynecologic oncologists and obstetrician-gynecologists had been described. The increased need for services from the female population of advanced ages was not included in the research, which instead concentrated on patients of reproductive age. For a study, researchers sought to assess the supply of obstetrician-gynecologists and gynecologic oncologists who treated US Medicare patients per 100,000 female beneficiaries over time, by state, and by area.

From the Physician and Other Supplier Public Use File database of Medicare Part B claims filed to the US Centers for Medicare & Medicaid Services, the supply of obstetrician-gynecologists and gynecologic oncologists was taken. Only 2012 to 2019’s worth of data was accessible. All numbers presented are providers per 100,000 female beneficiaries by state and were calculated using data from the Kaiser Family Foundation on the number of initial female Medicare beneficiaries. By comparing the provider-to-beneficiary ratio and the percentage change from 2012 to 2019, trends over time were evaluated. All information was gathered in 2021. SAS version 9.4 was used for all analyses. Institutional review board clearance of this study was waived.

All states together had 121.32 obstetrician-gynecologists per 100,000 female beneficiaries in 2019 (standard deviation±33.03). The District of Columbia, Connecticut, and Minnesota had the highest obstetrician-gynecologist-to-beneficiary ratios, while Montana (78.37), West Virginia (82.28), and Iowa (83.92) had the lowest ratios. The greatest ratios were in the District of Columbia (268.85), Connecticut (204.62), and Minnesota (171.60). Gynecologic oncologists made up an average of 4.48 physicians (SD = ±2.08). The District of Columbia, Rhode Island, and Connecticut had the greatest gynecologic oncologist-to-beneficiary ratios (11.30, 10.58, and 9.24, respectively), whereas Kansas (0.82), Vermont (1.41), and Mississippi (1.47) had the lowest ratios. Between 2012 and 2019, there was an 8.4% nationwide decline in the number of obstetricians and gynecologists per 100,000 female beneficiaries; the provider-to-beneficiary ratio varied from +29.97 (CT) to -82.62 (AK). Regionally, the number of obstetricians and gynecologists per 100,000 female beneficiaries decreased by -3.8% in the Northeast and -18.2% in the West. During the research period, there were 7.0% more gynecologic oncologists per 100,000 female beneficiaries nationwide; the range of this increase was from +8.96 (DC) to -3.39 (SD). Overall, the Midwest had a 15.4% rise while the West saw the most negligible gain (4.7%).

The availability and pace of expansion of obstetrician-gynecologists and gynecologic oncologists for the female Medicare population vary greatly by geography. The research shed light on regions of the nation where the demand for obstetrician-gynecologists and gynecologic oncologists may not be able to keep up with the supply. Alarmingly, the number of obstetrician-gynecologists across the country is declining, and it was especially true given that demographic predictions indicated that the proportion of older female patients will rise. Future research was required to discover why there were fewer Medicare clinicians accessible to visit patients and what minimal provider-to-enrollee ratios are required for gynecologic and cancer care. The findings may be used to assess whether certain states and areas are satisfying demand after such ratios have been created. To determine the impact of the COVID-19 pandemic on the supply of women’s health practitioners, more study was required.

Reference: ajog.org/article/S0002-9378(22)00727-X/fulltext