The Impact of Pediatrician Supply on Child Health Outcomes: Longitudinal Evidence from Japan
The Impact of Pediatrician Supply on Child Health Outcomes: Longitudinal Evidence from Japan
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DOI：
10.1111/1475-6773.12354
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发表时间：
2016-04-01
影响因子：
3.4
通讯作者：
Kawachi, Ichiro
中科院分区：
文献类型：
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作者：
Sakai, Rie;Fink, Guenther;Kawachi, Ichiro
目的探讨2000- 2010年日本5岁以下儿童死亡率与儿科医生供给的关系。资料来源采用多种公开资料，研究设计以日本366家二级医疗机构（STMCU）为研究单位。为了评估5岁以下儿童死亡率与儿科医生供应之间的关系，我们探索了时间和地区固定效应泊松回归模型。以下因素被引入模型中作为随时间变化的控制：（1）除5岁以下人口外，每总人口中除儿科医生外的医生数量，以及（2）按年和STMCU计算的每总人口的收入。进行了广泛的敏感性分析，以评估结果的鲁棒性。我们估计，在调整所有其他变量后，儿科医生密度的单位增加与儿童死亡率降低7%（95%CI：2- 12%）相关。结果是一致的，强大的所有规格tested.ConclusionsThe结果表明，增加人类卫生资源可以对儿童健康产生积极的影响，即使在儿童死亡率低于5每1,000人已经实现的设置。
ObjectiveTo investigate the effect of pediatrician supply on under-5 mortality over the period 2000-2010.Data SourcesMultiple publicly available data sources were used.Study DesignJapan's 366 Secondary Tier of Medical Care Units (STMCU) were used as study units. To evaluate the association between under-5 mortality and pediatrician supply, we explored time and area fixed-effects Poisson regression model. The following factors were introduced into the models as time-varying controls: (1) number of physicians other than pediatricians per total population except for under-5-year-old population, and (2) income per total population by year and STMCU. Extensive sensitivity analyses were conducted to assess robustness of results.Principal FindingsPediatrician density was inversely associated with under-5 mortality. We estimated that a unit increase in pediatrician density was associated with a 7 percent (95 percent CI: 2-12 percent) reduction in the child mortality rate after adjustment for all other variables. The results were consistent and robust across all specifications tested.ConclusionsThe results suggest that increasing human health resources can have positive effects on child health, even in settings where child mortality of less than 5 per 1,000 has been achieved.