The Impact of Pediatrician Supply on Child Health Outcomes: Longitudinal Evidence from Japan.

OBJECTIVE: To investigate the effect of pediatrician supply on under-5 mortality over the period 2000-2010. DATA SOURCES: Multiple publicly available data sources were used. STUDY
DESIGN: Japan'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
FINDINGS: Pediatrician 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.
CONCLUSIONS: The 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. © Health Research and Educational Trust.