A Spatial Analysis of Amyotrophic Lateral Sclerosis (ALS) Cases in the United States and their Proximity to Multidisciplinary ALS Clinics, 2013 (P5.164)

Objective: To provide a spatial representation of the location of multidisciplinary clinics(MDCs) in relation to prevalent cases of ALS across the United States to determine proximity and access to care. Background: Amyotrophic lateral sclerosis (ALS) is a fatal motor neuron disease that typically results in death within 2–5 years of initial symptom onset. Multidisciplinary ALS clinics (MDCs), often considered the gold standard of ALS care, have been established over the past few decades to provide comprehensive care for ALS patients (e.g., neurologists, occupational/physical therapists, dietitians, gastroenterologists, respiratory therapists, speech-language pathologists, and social workers). Design/Methods: The 2013 prevalent cases from the National ALS Registry were geocoded by city using geographic information system (GIS) software and mapped along with MDCs inoperation during 2013. Case-to-MDC proximity was analyzed and calculated by three categories: sex, race and age group. Cases were mapped by the U.S. Censusregions: Northeast, South, Midwest, and West. Results: In 2013, a total of 72 MDCs were in operation in 30 different states across the United States. Of the 15,908 ALS cases identified through the Registry, 15,633 (98.3%) were geocoded and distributed throughout all 50 states. Of the geocoded cases, 62.6% were male, 77.9% were white, and 76.2% were in the 50–79 year age range. Approximately 45% of all geocoded ALS cases lived >50 miles from a MDC and approximately 25% of these cases lived >100 miles from an MDC. Additionally, there was astatistically significant difference between distance to MDC by race and age group but not sex. Conclusions: This spatial analysis is the first to highlight the high percentage of ALS patients living more than 50 miles from specialized care clinics. Having better proximity to care is likely crucial in increasing survivability and providing appropriate treatment options and support for those living with this fatal disease. Disclosure: Dr. Horton has nothing to disclose. Dr. Graham MA has nothing to disclose. Dr. Punjani MPH has nothing to disclose. Dr. Wilt MPH has nothing to disclose. Dr. Kaye has nothing to disclose. Dr. Maginnis has nothing to disclose. Dr. Webb AM has nothing to disclose. Dr. Richman RN BSN has nothing to disclose. Dr. Bedlack has nothing to disclose. Dr. Tessaro has nothing to disclose. Dr. Mehta has nothing to disclose.