Journal of the American Academy of Dermatology
ReportsIncreasing supplies of dermatologists and family physicians are associated with earlier stage of melanoma detection☆,☆☆
Section snippets
Sources of data
We identified all 1994 incident cases of melanoma occurring in Florida for which stage at diagnosis was available (N = 1884) using the Florida Cancer Data System (FCDS), Florida’s population-based statewide cancer registry. The year 1994 was the most recent for which all relevant data were available. The FCDS was created in 1978 and has been collecting cancer incident data since 1981. The FCDS has well-established methods to ensure complete case finding including cooperative arrangements with
Results
Table I describes the demographic characteristics for the 1884 study subjects.
Characteristics No.* % Gender Male 1117 59.3 Female 767 40.7 Race/ethnicity White, non-Hispanic 1763 93.6 Black, non-Hispanic 15 0.8 Hispanic 62 3.3 Other 44 2.3 Education High school education 650 34.7 More than high school education 1225 65.4 Marital status Never 182 10.2 Current 1268 70.8 Divorced/separated 119 6.7 Widowed 224 12.5 Payer Medicare 669 43.7 Medicare HMO 64 4.2
Conclusions
Physician supply was a significant predictor of stage at diagnosis for patients with malignant melanoma. Most striking was the relation between the supply of dermatologists and stage; each additional dermatologist per 10,000 population was associated with 39% greater odds of early diagnosis. An increasing supply of family physicians was similarly associated with earlier diagnosis. Unexpectedly, an increasing supply of general internists was associated with greater odds of late stage diagnosis
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2022, Journal of the American Academy of DermatologyDoes more investment in primary care improve health system performance?
2021, Health PolicyCitation Excerpt :Lower rates of hospitalisation and fewer emergency department (ED) visits for ACSCs are strongly associated with the receipt of primary care [13,14]. Immunisation and screening rates have also been proposed as intermediate outcome measures, with several studies supporting the association of higher rates with primary care [14–23]. Increasing attention has also been paid to defining the features of strong primary care, with agreement that it should be: accessible, (geographically, financially and in terms of waiting times); comprehensive (offering a broad range of services, curative and preventive); continuous (meaning that the provider knows the medical history and the personal living situation of their patients); and co-ordinated (managing patient care across the health system) [6,24].
The flight of white-collars: Civil conflict, availability of medical service providers and public health
2016, Social Science and MedicineCitation Excerpt :Gai and Yan (2014) report a similar association between the supply of family physicians and influenza vaccination rates in the U.S. Lavy et al. (1996) find out that an increase in the number of doctors in Ghana would reduce the height gap between a Ghanaian child and an American child. Recent studies also document the positive impact of physician availability on cancer detection (Gorey et al., 2010; Roetzheim et al., 2000) and survival rates (Sundmacher and Busse, 2011; Ananthakrishnan et al., 2010). In light of these results, we argue that the flight of medical personnel away from conflict areas is an important mechanism through which civil conflicts hurt public health.
The expanding role of primary care in cancer control
2015, The Lancet OncologyEarly detection of melanoma: Reviewing the ABCDEs American Academy of Dermatology Ad Hoc Task Force for the ABCDEs of Melanoma
2015, Journal of the American Academy of Dermatology
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Dr Roetzheim was supported through a Generalist Physician Faculty Scholars Award from the Robert Wood Johnson Foundation.
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Reprint requests: Richard Roetzheim, MD, MSPH, University of South Florida, Department of Family Medicine, 12901 Bruce B. Downs Blvd, MDC 13, Tampa, FL 33612.