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Article
Does specialist physician supply affect pediatric asthma health outcomes?
BMC Health Services Research
  • Guido Filler, London Health Sciences Centre
  • Tom Kovesi, University of Ottawa
  • Erik Bourdon, Canadian Institute for Health Information
  • Sarah Ann Jones, London Health Sciences Centre
  • Laurentiu Givelichian, University of Saskatchewan
  • Cheryl Rockman-Greenberg, University of Manitoba
  • Jason A. Gilliland, Western University
  • Marion Williams, Paediatric Chairs of Canada
  • Elaine Orrbine, Paediatric Chairs of Canada
  • Bruno Piedboeuf, Laval University
Document Type
Article
Publication Date
4-1-2018
URL with Digital Object Identifier
https://doi.org/10.1186/s12913-018-3084-z
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.

Notes

Also available open access in BMC Health Services Research at: https://doi.org/10.1186/s12913-018-3084-z

Creative Commons License
Creative Commons Attribution 4.0
Citation Information
Filler, G., Kovesi, T., Bourdon, E. et al. Does specialist physician supply affect pediatric asthma health outcomes?. BMC Health Serv Res 18, 247 (2018). https://doi.org/10.1186/s12913-018-3084-z