title: Improving access to urologic care for rural populations through outreach clinics.
abstract: OBJECTIVE
  To determine the effect of outreach clinics on access to urologic care in a state with a large rural population. This is especially pertinent given the predicted shortage of urologists over the next decade and the trend toward practice in urban area.
  
  
  METHODS
  We analyzed provider level data from urologic practices within the state of Iowa using information from 2 publicly available sources: (1) the Office of Statewide (Iowa) Clinical Education Programs, which collects detailed information on visiting consultant urologists (VCU), and (2) the Iowa Physician Information System, which tracks demographic and professional data on all active physicians in Iowa. Factors analyzed included percent of counties and Iowans served by urologists and travel distances/times for patients and physicians.
  
  
  RESULTS
  Currently, 57% of Iowans are within 30 minutes of a urologist's primary office, increasing to 84% with VCU outreach clinics. Fifty-five urologists, including 40 of 69 (58%) of Iowa-based urologists, perform outreach within Iowa, accounting for 198 clinic days and 20,400 miles of travel per month.
  
  
  CONCLUSIONS
  Within Iowa, the lack of rural urologists has been mitigated, in part, by an extensive VCU network. However, improved access has required significant effort from urologists in both time and miles traveled. This study is the first to show how a rural state can effectively use physician outreach clinics to provide specialized urologic care to underserved, rural communities.
authors.affiliation: Department of Urology, University of Iowa, Carver College of Medicine, Iowa City, IA. Electronic address: matthew-uhlman@uiowa.edu.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Uhlman
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Gruca
authors.forename: Roger
authors.initials: R
authors.lastname: Tracy
authors.forename: Megan T
authors.initials: MT
authors.lastname: Bing
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Erickson
mesh_terms: D003151:Community Health Centers / Q000458:organization & administration; D003159:Community-Institutional Relations; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000639:trends; D006801:Humans; D012017:Referral and Consultation; D019035:Rural Health Services / Q000458:organization & administration* / Q000639:trends; D012424:Rural Population