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The Journal of the American Board of Family Practice, Vol 13, Issue 6 408-414, Copyright © 2000 by American Board of Family Practice

ARTICLES

Effects of physician supply on early detection of breast cancer

J. M. Ferrante, E. C. Gonzalez, N. Pal and R. G. Roetzheim
Department of Family Medicine, University of South Florida, and the H. Lee Moffitt Cancer Center & Research Institute, Tampa 33612, USA.

BACKGROUND: There are few studies examining the effects of physician supply on health-related outcomes. We hypothesized that increasing physician supply and, in particular, increasing primary care supply would be related to earlier detection of breast cancer. METHODS: Information on incident cases of breast cancer occurring in Florida in 1994 (n = 11,740) was collected from the state cancer registry. Measures of physician supply were obtained from the 1994 AMA Physician Masterfile. The effects of physician supply on the odds of late-stage diagnosis were examined using multiple logistic regression. RESULTS: There was no relation between overall physician supply and stage of breast cancer of diagnosis. Each 10th percentile increase in primary care physician supply, however, resulted in a 4% increase in the odds of early-stage diagnosis (adjusted odds ratio = 1.04, 95% confidence interval = 1.01-1.06). CONCLUSIONS: The supply of primary care physicians was significantly associated with earlier stage of breast cancer at diagnosis. This study suggests that an appropriate balance of primary care and specialty physician supply might be an important predictor of health outcomes.


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