POCUS access: Urban oases, rural deserts

Fewer than 40% of rural counties in the U.S. can offer residents any access to point-of-care ultrasound, while nearly 90% of their metropolitan counterparts have POCUS aplenty, according to a study published in the open-access journal Cureus.

Researchers at Carle Illinois College of Medicine, medical school of the University of Illinois Urbana-Champaign, made the finding after reviewing more than 30 million ultrasound-related CPT codes billed to Medicare from more than 3,000 counties between 2015 and 2019.

Of 30,135,085 codes included in the analysis, 73% reflected diagnostic exams and 27% ultrasound-guided procedures, corresponding author Nicholas Peterman and colleagues report.

To merge information germane to the CMS reimbursement records, the authors mined public datasets from the U.S. Department of Agriculture and other county-level sources for 39 variables indicative of socioeconomic, health and ultrasound characteristics.

Their key findings:

• 38.84% of rural counties had access to POCUS compared to 88.56% of metropolitan counties and 74.19% of counties overall.
• POCUS hotspots were concentrated in Southern California and Eastern states.
• Coldspot areas were conspicuous in the Great Plains and Midwest.
• Compared with coldspot clusters, hotspot clusters were significantly more densely populated, and residents were more urbanized, college-educated and likely to have been seen in an emergency department.
• Hotspot populations also were more likely to be obese (19.0% to 12.9%), less likely to be uninsured (10.1% to 13.0%), had more Black representation (8.5% to 3.4%) and less Hispanic representation (2.6% to 5.5%).