Sarma Sisira, Peddigrew Cory
Microsimulation Modelling & Data Analysis Division, Applied Research & Analysis Directorate, Health Policy Branch, Health Canada.
Cah Sociol Demogr Med. 2008 Jan-Mar;48(1):61-105.
This paper analyzes if and to what extent the density of family physicians influences health related outcomes in Canada. The density of family physicians in a given region is assumed to serve as proxy for the access to and availability of desirable primary care services. We use self-reported general and mental health status as our overall health outcome measures. We also use several quality of care indicators reflecting whether or not an individual received influenza immunization, mammography, pap smear, and colorectal cancer screening if at high-risk. The empirical results of this study suggest that an additional family physician per 10,000 population has a statistically significant impact in the order of 2% to 4% on self-reported general health status, as well as, other quality of care outcomes. We also find important socioeconomic and demographic factors, such as income, education and immigrant status, influencing health related outcomes considered in this study. Understanding the influence of physician density and socioeconomic factors on health related outcomes are important considerations for health policy and planning.
本文分析了加拿大的家庭医生密度是否以及在何种程度上会影响与健康相关的结果。假定某一地区的家庭医生密度可作为获得理想初级保健服务的可及性和可得性的替代指标。我们将自我报告的总体健康和心理健康状况作为整体健康结果指标。我们还使用了几个医疗质量指标，反映个体是否接受了流感疫苗接种、乳房X光检查、巴氏涂片检查以及高危人群是否接受了结肠直肠癌筛查。本研究的实证结果表明，每增加一名家庭医生/万人口，对自我报告的总体健康状况以及其他医疗质量结果会产生2%至4%的统计学显著影响。我们还发现重要的社会经济和人口因素，如收入、教育程度和移民身份，会影响本研究中所考虑的与健康相关的结果。了解医生密度和社会经济因素对与健康相关结果的影响，是卫生政策和规划的重要考量因素。
