ArticlePloS one2023
Racial & ethnic disparities in geographic access to critical care in the United States: A geographic information systems analysis.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Classifying healthcare facilities as predictors of COVID-19 mortality rates in US counties (2020-2021).Journal of public health (Oxford, England) · 2026Article
- Developing consensus-based indicators for intensive care unit capacity and capability in South Korea: a modified Delphi study.Acute and critical care · 2026Article
- Disparities in Venovenous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress by Sex, Region, and Socioeconomic Status.ASAIO journal (American Society for Artificial Internal Organs : 1992) · 2026Article
- Alcoholic and non-alcoholic acute pancreatitis mortality in the United States, 2006-2023: A nationwide trend analysis.Scientific reports · 2026Article
- Nationwide trends and disparities in deaths following cardiogenic shock and sepsis in the United States (1999-2023): insights from the CDC WONDER database.BMC cardiovascular disorders · 2025Article
- A Research Agenda to Mitigate Racial and Ethnic Disparities in U.S. Critical Care Medicine: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
- Unique Health Care Delivery Considerations in Rural America.International journal of MS care · 2024Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIt is important to identify gaps in access and reduce health outcome disparities, understanding access to intensive care unit (ICU) beds, especially by race and ethnicity, is crucial. Our objective was to evaluate the race and ethnicity-specific 60-minute drive time accessibility of ICU beds in the United States (US).
designWe conducted a cross-sectional study using road network analysis to determine the number of ICU beds within a 60-minute drive time, and calculated adult intensive care bed ratios per 100,000 adults. We evaluated the US population at the Census block group level and stratified our analysis by race and ethnicity and by urbanicity. We classified block groups into four access levels: no access (0 adult intensive care beds/100,000 adults), below average access (>0-19.5), average access (19.6-32.0), and above average access (>32.0). We calculated the proportion of adults in each racial and ethnic group within the four access levels.
settingAll 50 US states and the District of Columbia.
participantsAdults ≥15 years old.
main outcome measuresAdult intensive care beds/100,000 adults and percentage of adults national and state) within four access levels by race and ethnicity.
resultsHigh variability existed in access to ICU beds by state, and substantial disparities by race and ethnicity. 1.8% (n = 5,038,797) of Americans had no access to an ICU bed, and 26.8% (n = 73,095,752) had below average access, within a 60-minute drive time. Racial and ethnic analysis showed high rates of disparities (no access/below average access): American Indians/Alaskan Native 12.6%/28.5%, Asian 0.7%/23.1%, Black or African American 0.6%/16.5%, Hispanic or Latino 1.4%/23.0%, Native Hawaiian and other Pacific Islander 5.2%/35.0%, and White 2.1%/29.0%. A higher percentage of rural block groups had no (5.2%) or below average access (41.2%), compared to urban block groups (0.2% no access, 26.8% below average access).
conclusionICU bed availability varied substantially by geography, race and ethnicity, and by urbanicity, creating significant disparities in critical care access. The variability in ICU bed access may indicate inequalities in healthcare access overall by limiting resources for the management of critically ill patients.
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