ArticleCongenital heart disease2019
A model for geographic and sociodemographic access to care disparities for adults with congenital heart disease.
Article in Congenital heart disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Discontinuity of Cardiac Follow-Up in Young People With Congenital Heart Disease Transitioning to Adulthood: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2021Pooled it
- Social determinants of health and outcomes for children and adults with congenital heart disease: a systematic review.Pediatric research · 2021Pooled it
- Expanding Access to Specialized Adult Congenital Heart Disease Care Using a Hub-and-Spoke Model of Care.JACC. Case reports · 2026Article
- Adulting in the Current Era: Piloting an Individualized In-Person Congenital Heart Disease Transition Education Program.Pediatric cardiology · 2026Article
- Racial and Ethnic Differences in Healthcare Access and Utilization Among Adults With Congenital Heart Defects in the Congenital Heart Survey to Recognize Outcomes, Needs and Well-Being (CH STRONG).Birth defects research · 2026Article
- Sociodemographic and Clinical Predictors of Mortality in Adults With Congenital Heart Disease.Journal of the American Heart Association · 2026Article
- Development and multicentre validation of an artificial intelligence electrocardiogram model for ventricular remodeling in repaired tetralogy of Fallot.European heart journal. Digital health · 2026Article
- A Cluster Randomized Trial of an mHealth Intervention for Adolescents With Congenital Heart Disease: Rationale and Design of the READYorNot CHD Study.CJC pediatric and congenital heart disease · 2026Article
- Virtual transition education of rural adolescents with congenital heart disease: A pilot study.Health care transitions · 2026Article
- Characterizing Populations Based on Proximity to a Fragile X Syndrome Specialty Clinic.American journal on intellectual and developmental disabilities · 2026Article
- Longitudinal Intracardiac Right Ventricular Flow Analysis in Infants With Hypoplastic Left Heart Syndrome in Interstage I Using Novel Doppler Velocity Reconstruction.Journal of the American Heart Association · 2025Article
- Economic Barriers to Interventional Cardiology Care for Adults and Children With Congenital Heart Disease and Potential Policy Solutions: A SCAI Policy Statement.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Electrocardiogram-based deep learning to predict mortality in paediatric and adult congenital heart disease.European heart journal · 2025Article
- Adult Congenital Heart Disease in Serbia: Insights from a Single-Center Registry.Diagnostics (Basel, Switzerland) · 2025Article
- Impact of Remoteness of Residence and Socioeconomic Status on Outcomes Among Children With Heart Disease in Alberta.JACC. Advances · 2024Article
- Referral Order Placement Decreases Time to Transfer to Adult Congenital Heart Disease Care.Pediatric cardiology · 2024Article
- Rationale and design of a randomized controlled clinical trial of a resilience-building intervention in adults with congenital heart disease.Contemporary clinical trials · 2024Article
- Improving Maternal Outcomes in Congenital Heart Disease: A National Call to Action.JACC. Advances · 2024Article
- Racial Disparity: The Adult Congenital Heart Disease Surgery Perspective.Pediatric cardiology · 2024Article
- Impact of Social Determinants of Health on Outcomes for Patients with Adult Congenital Heart Disease.Current cardiology reports · 2024Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundFollow-up at a regional adult congenital heart disease (ACHD) center is recommended for all ACHD patients at least once per the 2018 ACC/AHA guidelines. Other specialties have demonstrated poorer follow-up and outcomes correlating with increased distance from health care providers, but driving time to regional ACHD centers has not been examined in the US population.
objectiveTo identify and characterize potential disparities in access to ACHD care in the US based on drive time to ACHD centers and compounding sociodemographic factors.
methodsMid- to high-volume ACHD centers with ≥500 outpatient ACHD visits and ≥20 ACHD surgeries annually were included based on self-reported, public data. Geographic Information System mapping was used to delineate drive times to ACHD centers. Sociodemographic data from the 2012-2016 American Community Survey (US Census) and the Environmental Systems Research Institute were analyzed based on drive time to nearest ACHD center. Previously established CHD prevalence estimates were used to estimate the similarly located US ACHD population.
resultsNearly half of the continental US population (45.1%) lives >1 hour drive to an ACHD center. Overall, 39.7% live 1-4 hours away, 3.4% live 4-6 hours away, and 2.0% live >6 hours away. Hispanics were disproportionately likely to live a >6 hour drive to a center (p < .001). Compared to people with <1 hour drive, those living >6 hours away have higher proportions of uninsured adults (29% vs. 18%; p < .001), households below the federal poverty level (19% vs. 13%; p < .001), and adults with less than college education (18% vs. 12%; p < .001).
conclusionsWe estimate that ~45% of the continental US population lives >1 hour to an ACHD center, with 5.4% living >4 hours away. Compounding barriers exist for Hispanic, uninsured, lower socioeconomic status, and less-educated patients. These results may help drive future policy changes to improve access to ACHD care.
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