Increasing supplies of dermatologists and family physicians are associated with earlier stage of melanoma detection

Roetzheim, Richard G.; Pal, Naazneen; Durme, Daniel J. Van; Wathington, Deanna; Ferrante, Joan M.; Gonzalez, Eduardo; Krischer, Jeffrey P.

doi:10.1067/mjd.2000.106242

Cited by 70 publications

(44 citation statements)

References 40 publications

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“…In contrast, there is no relationship between the supply of other specialists and early detection of melanoma. 21 A national study of one-year mortality among elderly adults with acute myocardial infarction (AMI) showed no differences between care provided by cardiologists and family physicians once a variety of characteristics (including comorbidity and use of guidelines) were controlled for, a finding that was considered to confirm the results of other cited studies. 22 In that study, the patients of cardiologists were less ill overall, with fewer comorbid illnesses than the patients of primary care physicians.…”

Section: Study Resultssupporting

confidence: 71%

The Effects Of Specialist Supply On Populations’ Health: Assessing The Evidence

et al. 2005

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Analyses at the county level show lower mortality rates where there are more primary care physicians, but this is not the case for specialist supply. These findings confirm those of previous studies at the state and other levels. Increasing the supply of specialists will not improve the United States' position in population health relative to other industrialized countries, and it is likely to lead to greater disparities in health status and outcomes. Adverse effects from inappropriate or unnecessary specialist use may be responsible for the absence of relationship between specialist supply and mortality. M a n y i n t e r nat i o na l c o m pa r i s o n s and within-country studies confirm the relationship between the adequacy of a health system's primary care infrastructure and better health outcomes.1 This study examines the heretofore unexplored relationship between specialist physician supply and death rates, based on data from U.S counties. After presenting our analysis, we discuss the complicated issues surrounding specialist supply and population health and the policy implications of our findings. Study Data And MethodsThe period 1996-2000 is the most recent containing the complete set of our chosen study variables for 3,075 counties (99.9 percent of all U.S. counties). We used counties so that we could determine the robustness of prior state-level analyses.Age-adjusted standardized mortality rates are expressed as the number of deaths per 1,000 population. All-cause mortality is among the most commonly used health status indicators, especially in studies on income inequality and health.2 Heart disease and cancer are the two specific leading causes of death. Regarding the definition of specialist versus primary care, physicians engaging in office-

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Section: Study Resultssupporting

confidence: 71%

The Effects Of Specialist Supply On Populations’ Health: Assessing The Evidence

et al. 2005

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“…54,55,59,60 Greater site and interpersonal continuity are also associated with increased use of preventive services and guideline-concordant care. [61][62][63][64][65][66][67][68] Interpersonal continuity is highly valued by both patients and providers, and it has been associated with better adherence to provider recommendations. [69][70][71] Comprehensive primary care, which involves meeting the large majority of each patient's physical and mental health care needs, has been associated with better health outcomes provided at lower cost, 11,14,17,23,72,73 lower hospitalization rates for ambulatory care-sensitive conditions, 14,74 improved health and better self-reported health outcomes, 11,14,17,72,75 and greater equity (i.e., reduced disparities in disease severity as a result of earlier detection and prevention across different populations).…”

Section: Primary Care Features and Associations With Patient Outcomesmentioning

confidence: 99%

Disentangling the Linkage of Primary Care Features to Patient Outcomes: A Review of Current Literature, Data Sources, and Measurement Needs

et al. 2015

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Primary care plays a central role in the provision of health care, and is an organizing feature for health care delivery systems in most Western industrialized democracies. For a variety of reasons, however, the practice of primary care has been in decline in the U.S. This paper reviews key primary care concepts and their definitions, notes the increasingly complex interplay between primary care and the broader health care system, and offers research priorities to support future measurement, delivery and understanding of the role of primary care features on health care costs and quality.

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“…[27][28][29][30][31] Thus, general practice can provide timely and comprehensive cancer diagnosis when given the proper conditions for, for example, diagnostic work-up and referral of patients.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%