Miriam N Lango1, Elizabeth Handorf2, Ellis Arjmand3. 1. Department of Surgical Oncology, Head and Neck Surgery Section, Fox Chase Cancer Center, and the Department of Otolaryngology, Temple University School of Medicine, Temple University Health System, Philadelphia, Pennsylvania, U.S.A. 2. Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania, U.S.A. 3. Department of Surgery (Otolaryngology), Texas Children's Hospital, and the Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.
Abstract
OBJECTIVES: To describe the deployment of otolaryngologists and evaluate factors associated with the geographic distribution of otolaryngologists in the United States. STUDY DESIGN: Cross-sectional study. METHODS: The otolaryngology physician supply was defined as the number of otolaryngologists per 100,000 in the hospital referral region (HRR). The otolaryngology physician supply was derived from the American Medical Association Masterfile or from the Medicare Enrollment and Provider Utilization Files. Multiple linear regression tested the association of population, physician, and hospital factors on the supply of Medicare-enrolled otolaryngologists/HRR. RESULTS: Two methods of measuring the otolaryngology workforce were moderately correlated across hospital referral regions (Pearson coefficient 0.513, P = .0001); regardless, the supply of otolaryngology providers varies greatly over different geographic regions. Otolaryngologists concentrate in regions with many other physicians, particularly specialist physicians. The otolaryngology supply also increases with regional population income and education levels. Using AMA-derived data, there was no association between the supply of otolaryngologists and staffed acute-care hospital beds and the presence of an otolaryngology residency-training program. In contrast, the supply of otolaryngology providers enrolled in Medicare independently increases for each HRR by 0.8 per 100,000 for each unit increase in supply of hospital beds (P < .0001) and by 0.49 per 100,000 in regions with an otolaryngology residency-training program (P = .006), accounting for all other factors. CONCLUSION: Irrespective of methodology, the supply of otolaryngologists varies widely across geographic regions in the United States. For Medicare beneficiaries, regional hospital factors-including the presence of an otolaryngology residency program-may improve access to otolaryngology services. LEVEL OF EVIDENCE: NA Laryngoscope, 127:95-101, 2017.
OBJECTIVES: To describe the deployment of otolaryngologists and evaluate factors associated with the geographic distribution of otolaryngologists in the United States. STUDY DESIGN: Cross-sectional study. METHODS: The otolaryngology physician supply was defined as the number of otolaryngologists per 100,000 in the hospital referral region (HRR). The otolaryngology physician supply was derived from the American Medical Association Masterfile or from the Medicare Enrollment and Provider Utilization Files. Multiple linear regression tested the association of population, physician, and hospital factors on the supply of Medicare-enrolled otolaryngologists/HRR. RESULTS: Two methods of measuring the otolaryngology workforce were moderately correlated across hospital referral regions (Pearson coefficient 0.513, P = .0001); regardless, the supply of otolaryngology providers varies greatly over different geographic regions. Otolaryngologists concentrate in regions with many other physicians, particularly specialist physicians. The otolaryngology supply also increases with regional population income and education levels. Using AMA-derived data, there was no association between the supply of otolaryngologists and staffed acute-care hospital beds and the presence of an otolaryngology residency-training program. In contrast, the supply of otolaryngology providers enrolled in Medicare independently increases for each HRR by 0.8 per 100,000 for each unit increase in supply of hospital beds (P < .0001) and by 0.49 per 100,000 in regions with an otolaryngology residency-training program (P = .006), accounting for all other factors. CONCLUSION: Irrespective of methodology, the supply of otolaryngologists varies widely across geographic regions in the United States. For Medicare beneficiaries, regional hospital factors-including the presence of an otolaryngology residency program-may improve access to otolaryngology services. LEVEL OF EVIDENCE: NA Laryngoscope, 127:95-101, 2017.
Authors: M Kelsey Kirkwood; Suanna S Bruinooge; Michael A Goldstein; Dean F Bajorin; Michael P Kosty Journal: J Oncol Pract Date: 2014-01 Impact factor: 3.840
Authors: Shannon P Pryor; Linda Brodsky; Sujana S Chandrasekhar; Lauren Zaretsky; Duane J Taylor; Kathleen L Yaremchuk; Harold C Pillsbury Journal: Otolaryngol Head Neck Surg Date: 2012-02 Impact factor: 3.497