Patient Travel Distance to Neurologist Visits.

quintile), rural setting (4.89[4.79-4.99]), long-distance travel to primary care physician visit (3.6 [3.51-3.69]), and visits for ALS and nervous system cancer care (3.41[3.14-3.69] and 5.27[4.72-5.89], respectively). Nearly one third of patients bypassed the nearest neurologist by 20+ miles and 7.3% of patients crossed state lines for neurologist care CONCLUSIONS: We found that nearly 1 in 5 Medicare beneficiaries who saw a neurologist traveled ≥50 miles one-way for care and travel burden was most common for lower prevalence neurologic conditions that required coordinated multidisciplinary care. Important potentially addressable predictors of long-distance travel were low neurologist density and rural location, suggesting interventions to improve access to care such as telemedicine or neurological subspecialist support to local neurologists. Future work should evaluate differences in clinical outcomes between patients with long-distance travel and those without.