Does specialist physician supply affect pediatric asthma health outcomes?

Abstract

BackgroundPediatrician 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.MethodsThis 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.ResultsAt 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).ConclusionsSaskatchewan, 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.

Childhood Asthma – The Effect of Asthma Specialist Intervention on Asthma Control: A Retrospective Review

“…Nonetheless, these data are supported by a retrospective, cross-sectional study from Canada that demonstrated a strong connection between the lack of asthma specialists and hospital admissions of children with asthma. 10 Childhood asthma is a heterogeneous condition with wide variability among patients. 16 It is reasonable to assume that not all patients who meet with a specialist will benefit directly from a single encounter.…”

“…8,9 Although recommended for children, the effect of asthma specialists' intervention on asthma control in the pediatric population is much less explored. [9][10][11] The current study evaluated the effect of asthma specialists' intervention on asthma control, in a large group of Israeli children.…”

Correction to: Does specialist physician supply affect pediatric asthma health outcomes?

“…In the original publication of this article [1], the institutional author’s name needs to be revised from The Paediatric Chairs of Canada Mark Bernstein to The Paediatric Chairs of Canada.…”