Dayan Akin, Unal Erdinc, Tural Egemen
Department of Family Medicine, Diabetes Polyclinic, Haydarpasa Numune Training and Research Hospital, Koşuyolu, Kalfaçeşme sok. No: 1, Üsküdar, Istanbul, 34662, Turkey.
Department of Health Management, Ardahan University Faculty of Health Sciences, Ardahan Çıldır cad., Ardahan Center, Ardahan, 75000, Turkey.
BMC Health Serv Res. 2025 Jun 2;25(1):785. doi: 10.1186/s12913-025-12919-y.
Evaluating health outcomes is essential for identifying health-related needs; ensuring an adequate number of physicians, their specialties, and their distribution; and formulating new health policies. The causes of death are significant health outcomes. Moreover, there is a strong correlation between a region’s developmental level and cause-specific deaths. This study analysed data from Turkey between 2010 and 2014 to explore the relationship between the number of cases of cause-specific mortality in individuals aged 45 years and older, infant mortality rates (IMR) and total mortality rates in the 15–44 years age group and the availability of general practitioners (GPs) and specialists, aiming to understand the impact of physician numbers on mortality rates.
This is a retrospective longitudinal study that encompasses an analysis of all 81 provinces in Turkey. The dependent variable is the number of cause-specific deaths, while the independent variables include the number of physicians by specialty, income level, number of hospital beds, and number of high school graduates. Linear regression models with random effects were utilized for statistical analysis, facilitating the calculation of coefficients for each province.
The results revealed a significant negative correlation between the number of GPs and mortality due to ischaemic heart disease (IHD), central nervous system diseases (CNSD), malignancies, diabetes, and IMR. As the number of GPs increased, the rates of these mortalities decreased. The availability of cardiologists was negatively correlated with mortality from IHD, and the availability of neurologists was negatively correlated with mortality from CNSD. The overall specialist ratio was negatively correlated with the mortality rate in individuals aged 15–44 years. The number of deaths from chronic diseases was higher in the more developed western regions of the country. In contrast, mortality rates among those aged 15–44 years and infant mortality rates were higher in the eastern provinces.
The number of GPs significantly impacts the reduction in the number of deaths from chronic diseases and IMR. Strengthening primary care services by increasing the number of GPs who can reach a wider population effectively and cost-efficiently will be a key factor in improving public health.
评估健康结果对于确定与健康相关的需求、确保医生数量充足及其专业和分布情况以及制定新的卫生政策至关重要。死亡原因是重要的健康结果。此外，一个地区的发展水平与特定原因导致的死亡之间存在很强的相关性。本研究分析了2010年至2014年土耳其的数据，以探讨45岁及以上个体特定原因死亡率、15 - 44岁年龄组的婴儿死亡率（IMR）和总死亡率与全科医生（GP）和专科医生数量之间的关系，旨在了解医生数量对死亡率的影响。
这是一项回顾性纵向研究，涵盖对土耳其所有81个省份的分析。因变量是特定原因死亡人数，自变量包括各专科医生数量、收入水平、医院病床数量和高中毕业生数量。采用具有随机效应的线性回归模型进行统计分析，便于计算每个省份的系数。
结果显示，全科医生数量与缺血性心脏病（IHD）、中枢神经系统疾病（CNSD）、恶性肿瘤、糖尿病导致的死亡率以及婴儿死亡率之间存在显著负相关。随着全科医生数量的增加，这些死亡率降低。心脏病专家的数量与IHD死亡率呈负相关，神经科医生的数量与CNSD死亡率呈负相关。专科医生的总体比例与15 - 44岁个体的死亡率呈负相关。该国较发达的西部地区慢性病死亡人数较高。相比之下，东部省份15 - 44岁人群的死亡率和婴儿死亡率较高。
全科医生数量对降低慢性病死亡人数和婴儿死亡率有显著影响。通过增加能够有效且经济高效地覆盖更广泛人群的全科医生数量来加强初级保健服务，将是改善公众健康的关键因素。
