Supply and Distribution of Vascular Access Physicians in the United States: A Cross-Sectional Study
| Autor: | Diane Steffick, Virginia Wang, Shoou Yih D. Lee, Jie Xiang, Rajiv Saran, Abhijit V. Kshirsagar |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Referral Cross-sectional study medicine.medical_treatment Arteriovenous fistula Article symbols.namesake Arteriovenous Shunt Surgical Renal Dialysis Physicians Health care medicine Humans Poisson regression Socioeconomic status Retrospective Studies business.industry General Medicine Middle Aged medicine.disease Physician supply United States Cross-Sectional Studies Treatment Outcome Emergency medicine symbols Kidney Failure Chronic Hemodialysis business |
| Zdroj: | Kidney360 |
| ISSN: | 2641-7650 |
| Popis: | BACKGROUND: Because functioning permanent vascular access (arteriovenous fistula [AVF] or arteriovenous graft [AVG]) is crucial for optimizing patient outcomes for those on hemodialysis, the supply of physicians placing vascular access is key. We investigated whether area-level demographic and healthcare market attributes were associated with the distribution and supply of AVF/AVG access physicians in the United States. METHODS: A nationwide registry of physicians placing AVFs/AVGs in 2015 was created using data from the United States Renal Data System and the American Physician Association’s Physician Masterfile. We linked the registry information to the Area Health Resource File to assess the supply of AVF/AVG access physicians and their professional attributes by hospital referral region (HRR). Bivariate analysis and Poisson regression were performed to examine the relationship between AVF/AVG access physician supply and demographic, socioeconomic, and health resource conditions of HRRs. The setting included all 50 states. The main outcome was supply of AVF/AVG access physicians, defined as the number of physicians performing AVF and/or AVG placement per 1000 prevalent patients with ESKD. RESULTS: The majority of vascular access physicians were aged 45–64 (average age, 51.6), male (91%), trained in the United States (76%), and registered in a surgical specialty (74%). The supply of physicians varied substantially across HRRs. The supply was higher in HRRs with a higher percentage white population (β=0.44; SEM=0.14; P=0.002), lower unemployment rates (β=−10.74; SEM=3.41; P=0.002), and greater supply of primary care physicians (β=0.18; SEM=0.05; P=0.001) and nephrologists (β=15.89; SEM=1.22; P |
| Databáze: | OpenAIRE |
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