Impact of Endocrinologist and Surgeon Density on Well-Differentiated Thyroid Cancer Survival.
Am Surg
; 88(11): 2626-2632, 2022 Nov.
Article
em En
| MEDLINE
| ID: mdl-35591793
ABSTRACT
BACKGROUND:
The influence of provider density and access on well-differentiated thyroid cancer (DTC) survival is uncertain.METHODS:
We used the SEER18 database to study DTC patients undergoing surgery from 2000-2012. County-level endocrinologist and surgeon density were calculated. We evaluated the relationship between provider density and cause-specific survival controlling for demographic, socioeconomic, and treatment characteristics.RESULTS:
Median endocrinologist density was 1.4/100 000 residents, with 15.5% of patients living in a county with no endocrinologist. Survival increased by 11% for each endocrinologist/100,000 people (P = .007). Median surgeon density was 14.8/100 000 residents, with only 1.7% of patients living in a county with no general surgeon or otolaryngologist. No significant association between surgeon density and survival was identified (P = .06). Rural residence was independently associated with lower survival (P = .009).CONCLUSIONS:
County-level endocrinologist density is associated with improved DTC survival. Results may reflect endocrinologist expertise, earlier diagnosis, or represent surrogacy for higher county-level access to specialized care.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Glândula Tireoide
/
Adenocarcinoma
/
Cirurgiões
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article