Does specialist physician supply affect pediatric asthma health outcomes?

Abstract Background Pediatrician and pediatric subspecialist density varies substantially among the various Canadian provinces, as well as among various states in the US. It is unknown whether this variability impacts health outcomes. To study this knowledge gap, we evaluated pediatric asthma admiss...

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Main Authors: Guido Filler, Tom Kovesi, Erik Bourdon, Sarah Ann Jones, Laurentiu Givelichian, Cheryl Rockman-Greenberg, Jason Gilliland, Marion Williams, Elaine Orrbine, Bruno Piedboeuf, The Paediatric Chairs of Canada Mark Bernstein
Format: Article
Language:English
Published: BMC 2018-04-01
Series:BMC Health Services Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12913-018-3084-z
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spelling doaj-c78d64bbc68547e78a0dc8e7eed13c392020-11-24T23:34:59ZengBMCBMC Health Services Research1472-69632018-04-011811810.1186/s12913-018-3084-zDoes specialist physician supply affect pediatric asthma health outcomes?Guido Filler0Tom Kovesi1Erik Bourdon2Sarah Ann Jones3Laurentiu Givelichian4Cheryl Rockman-Greenberg5Jason Gilliland6Marion Williams7Elaine Orrbine8Bruno Piedboeuf9The Paediatric Chairs of Canada Mark BernsteinDepartments of Peediatrics, Children’s Hospital at London Health Sciences Centre, University of Western OntarioDepartment of Pediatrics, Children’s Hospital of Eastern Ontario, University of OttawaThe Canadian Institute for Health Information (CIHI)Departments of Peediatrics, Children’s Hospital at London Health Sciences Centre, University of Western OntarioDepartment of Pediatrics, University of SaskatchewanDepartment of Pediatrics and Child Health, University of ManitobaDepartments of Peediatrics, Children’s Hospital at London Health Sciences Centre, University of Western OntarioPaediatric Chairs of Canada (PCC)Paediatric Chairs of Canada (PCC)Department of Pediatrics, University Laval, Faculty of MedicineAbstract Background Pediatrician and pediatric subspecialist density varies substantially among the various Canadian provinces, as well as among various states in the US. It is unknown whether this variability impacts health outcomes. To study this knowledge gap, we evaluated pediatric asthma admission rates within the 2 Canadian provinces of Manitoba and Saskatchewan, which have similarly sized pediatric populations and substantially different physician densities. Methods This was a retrospective cross-sectional cohort study. Health regions defined by the provincial governments, have, in turn, been classified into “peer groups” by Statistics Canada, on the basis of common socio-economic characteristics and socio-demographic determinants of health. To study the relationship between the distribution of the pediatric workforce and health outcomes in Canadian children, asthma admission rates within comparable peer group regions in both provinces were examined by combining multiple national and provincial health databases. We generated physician density maps for general practitioners, and general pediatricians practicing in Manitoba and Saskatchewan in 2011. Results At the provincial level, Manitoba had 48.6 pediatricians/100,000 child population, compared to 23.5/100,000 in Saskatchewan. There were 3.1 pediatric asthma specialists/100,000 child population in Manitoba and 1.4/100,000 in Saskatchewan. Among peer-group A, the differences were even more striking. A significantly higher number of patients were admitted in Saskatchewan (590.3/100,000 children) compared to Manitoba (309.3/100,000, p < 0.0001). Conclusions Saskatchewan, which has a lower pediatrician and pediatric asthma specialist supply, had a higher asthma admission rate than Manitoba. Our data suggest that there is an inverse relationship between asthma admissions and pediatrician and asthma specialist supply.http://link.springer.com/article/10.1186/s12913-018-3084-zHealth manpower/trendsPhysicians/supply and distributionPediatricGeneral practitioners
collection DOAJ
language English
format Article
sources DOAJ
author Guido Filler
Tom Kovesi
Erik Bourdon
Sarah Ann Jones
Laurentiu Givelichian
Cheryl Rockman-Greenberg
Jason Gilliland
Marion Williams
Elaine Orrbine
Bruno Piedboeuf
The Paediatric Chairs of Canada Mark Bernstein
spellingShingle Guido Filler
Tom Kovesi
Erik Bourdon
Sarah Ann Jones
Laurentiu Givelichian
Cheryl Rockman-Greenberg
Jason Gilliland
Marion Williams
Elaine Orrbine
Bruno Piedboeuf
The Paediatric Chairs of Canada Mark Bernstein
Does specialist physician supply affect pediatric asthma health outcomes?
BMC Health Services Research
Health manpower/trends
Physicians/supply and distribution
Pediatric
General practitioners
author_facet Guido Filler
Tom Kovesi
Erik Bourdon
Sarah Ann Jones
Laurentiu Givelichian
Cheryl Rockman-Greenberg
Jason Gilliland
Marion Williams
Elaine Orrbine
Bruno Piedboeuf
The Paediatric Chairs of Canada Mark Bernstein
author_sort Guido Filler
title Does specialist physician supply affect pediatric asthma health outcomes?
title_short Does specialist physician supply affect pediatric asthma health outcomes?
title_full Does specialist physician supply affect pediatric asthma health outcomes?
title_fullStr Does specialist physician supply affect pediatric asthma health outcomes?
title_full_unstemmed Does specialist physician supply affect pediatric asthma health outcomes?
title_sort does specialist physician supply affect pediatric asthma health outcomes?
publisher BMC
series BMC Health Services Research
issn 1472-6963
publishDate 2018-04-01
description Abstract Background Pediatrician and pediatric subspecialist density varies substantially among the various Canadian provinces, as well as among various states in the US. It is unknown whether this variability impacts health outcomes. To study this knowledge gap, we evaluated pediatric asthma admission rates within the 2 Canadian provinces of Manitoba and Saskatchewan, which have similarly sized pediatric populations and substantially different physician densities. Methods This was a retrospective cross-sectional cohort study. Health regions defined by the provincial governments, have, in turn, been classified into “peer groups” by Statistics Canada, on the basis of common socio-economic characteristics and socio-demographic determinants of health. To study the relationship between the distribution of the pediatric workforce and health outcomes in Canadian children, asthma admission rates within comparable peer group regions in both provinces were examined by combining multiple national and provincial health databases. We generated physician density maps for general practitioners, and general pediatricians practicing in Manitoba and Saskatchewan in 2011. Results At the provincial level, Manitoba had 48.6 pediatricians/100,000 child population, compared to 23.5/100,000 in Saskatchewan. There were 3.1 pediatric asthma specialists/100,000 child population in Manitoba and 1.4/100,000 in Saskatchewan. Among peer-group A, the differences were even more striking. A significantly higher number of patients were admitted in Saskatchewan (590.3/100,000 children) compared to Manitoba (309.3/100,000, p < 0.0001). Conclusions Saskatchewan, which has a lower pediatrician and pediatric asthma specialist supply, had a higher asthma admission rate than Manitoba. Our data suggest that there is an inverse relationship between asthma admissions and pediatrician and asthma specialist supply.
topic Health manpower/trends
Physicians/supply and distribution
Pediatric
General practitioners
url http://link.springer.com/article/10.1186/s12913-018-3084-z
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