scholarly journals Feminization of the rheumatology workforce: A longitudinal evaluation of patient volumes, practice sizes and physician remuneration

2020 ◽  
pp. jrheum.201166
Author(s):  
Jessica Widdifield ◽  
Jodi M. Gatley ◽  
Janet E. Pope ◽  
Claire E.H. Barber ◽  
Bindee Kuriya ◽  
...  
Keyword(s):  
Workforce Planning ◽  
Population Based ◽  
Annual Number ◽  
Clinical Activity ◽  
Full Time ◽  
Fee For Service ◽  
Population Based Study ◽  
Male And Female ◽  
Practice Size ◽  
Physician Remuneration

Objective To compare differences in clinical activity and remuneration between male and female rheumatologists and to evaluate associations between physician gender and practice sizes and patient volume, accounting for rheumatologists’ age, and calendar year effects. Methods We conducted a population-based study in Ontario, Canada between 2000-2015 identifying all rheumatologists practicing as full-time equivalents (FTE) or above and assessed differences in practice sizes (number of unique patients), practice volumes (number of patient visits), and remuneration (total fee-for-service billings) between male and female rheumatologists. Multivariable linear regression was used to evaluate the effects of gender on practice size and volume separately, accounting for age and year. Results The number of rheumatologists practicing at or above one FTE increased from 89 to 120 from 2000 to 2015, with the percentage of females increasing from 27.0% to 41.7%. Males had larger practice sizes and practice volumes. Remuneration was consistently higher for males (between $46,000-$102,000 annually). Our adjusted analyses estimated that in a given year, males saw a mean of 606 (95% CI 107-1105) more patients than females did, and had 1,059 (95% CI 345- 1773) more patient visits. Among males and females combined, there was a small but statistically significant reduction in mean annual number of patient visits, and middle-aged rheumatologists had greater practice sizes and volumes than their younger/older counterparts. Conclusion On average, female rheumatologists saw fewer patients and had fewer patient visits annually relative to males, resulting in lower earnings. Increasing feminization necessitates workforce planning to ensure that populations’ needs are met.

scholarly journals Encounters with Rheumatologists in a Publicly Funded Canadian Healthcare System: A Population-based Study

2019 ◽  
Vol 47 (3) ◽  
pp. 468-476 ◽  
Author(s):  
Jessica Widdifield ◽  
Sasha Bernatsky ◽  
Janet E. Pope ◽  
Vandana Ahluwalia ◽  
Claire E.H. Barber ◽  
...  
Keyword(s):  
Healthcare System ◽  
Clinical Care ◽  
Workforce Planning ◽  
Population Level ◽  
Population Based ◽  
Annual Number ◽  
Clinical Activity ◽  
Full Time ◽  
Population Based Study ◽  
Over Time

Objective.To quantify population-level and practice-level encounters with rheumatologists over time.Methods.We conducted a population-based study from 2000 to 2015 in Ontario, Canada, where all residents are covered by a single-payer healthcare system. Annual total number of unique patients seen by rheumatologists, the number of new patients seen, and total number of encounters with rheumatologists were identified.Results.From 2000 to 2015, the percentage of the population seen by rheumatologists was constant over time (2.7%). During this time, Ontario had a stable supply of rheumatologists (0.8 full-time equivalents/75,000). From 2000 to 2015, the number of annual rheumatology encounters increased from 561,452 to 786,061, but the adjusted encounter rates remained stable over time (at 62 encounters per 1000 population). New patient assessment rates declined over time from 10 new outpatient assessments per 1000 in 2000 to 6 per 1000 in 2015. The crude volume of new patients seen annually decreased and an increasing proportion of rheumatology encounters were with established patients. We observed a shift in patient case mix over time, with more assessments for systemic inflammatory conditions. Rheumatologists’ practice volumes, practice sizes, and the annual number of days providing clinical care decreased over time.Conclusion.Over a 15-year period, the annual percentage of the population seen by a rheumatologist remained constant and the volume of new patients decreased, while followup patient encounters increased. Patient encounters per rheumatologist decreased over time. Our findings provide novel information for rheumatology workforce planning. Factors affecting clinical activity warrant further research.

scholarly journals Humidifier Disinfectant Consumption and Humidifier Disinfectant-Associated Lung Injury in South Korea: A Nationwide Population-Based Study

2021 ◽  
Vol 18 (11) ◽  
pp. 6136
Author(s):  
Jeonggyo Yoon ◽  
Minsun Kang ◽  
Jaehun Jung ◽  
Min Jae Ju ◽  
Sung Hwan Jeong ◽  
...  
Keyword(s):  
Health Insurance ◽  
Lung Injury ◽  
National Health Insurance ◽  
Population Based ◽  
Annual Number ◽  
Population Based Study ◽  
Annual Consumption ◽  
Using Data ◽  
Water Tanks ◽  
Biocidal Product

Humidifier disinfectant (HD) is a household biocidal product used in humidifier water tanks to prevent the growth of microorganisms. In 2011, a series of lung injury cases of unknown causes emerged in children and pregnant women who had used HD in Korea. This study investigated changes in the nationwide number of cases of humidifier disinfectant-associated lung injury (HDLI) in concordance with nationwide HD consumption using data covering the entire Korean population. More than 25 kinds of HD products were sold between 1994 and 2011. The number of diagnosed HDLI, assessed by S27.3 (other injuries of lungs) of the Korea National Health Insurance Service (NHIS) data, sharply increased by 2005, subsequently decreased after 2005, and almost disappeared after 2011 in concordance with the annual number of HD sales. The number of self-reported HDLIs, assessed using data from all suspected HDLI cases registered in the Korea Ministry of Environment, changed with the annual number of HD sales, with a delay pattern, potentially induced by the late awareness of lung injury diseases. The present study suggests that changes in the nationwide annual consumption of HD products were consistent with changes in the annual number of HDLI cases in Korea.

Analyzing Survival Trends in Multiple Myeloma Patients in Pre and Post-Bortezomib Era Using the SEER Database

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2639-2639
Author(s):  
Jayadev Manikkam Umakanthan ◽  
Dipesh Uprety ◽  
Vineela Kasireddy
Keyword(s):  
Multiple Myeloma ◽  
Survival Rate ◽  
Survival Rates ◽  
Relative Survival ◽  
Population Based ◽  
P Value ◽  
Relative Standard Error ◽  
Population Based Study ◽  
Male And Female ◽  
Relative Standard

Abstract Background: Bortezomib is an antineoplastic agent that acts through protease inhibition. Since, its approval in 2003 by U.S. Food and Drug administration, it has been used religiously for multiple myeloma. There is no current population based study that assesses the survival benefit in multiple myeloma from bortezomib. We conducted a population based study to evaluate the relative survival rates in multiple myeloma patients in pre and post-Bortezomib era in the United States. Methods: We analyzed the Surveillance, Epidemiology, and End Results (SEER) 18 registry database to compare five-year relative survival rates (RS) among multiple myeloma patients. The study arms were categorized by gender (male and female), race (Caucasians and African-Americans) and age (20-59, ≥60 years). The RS were compared between pre-bortezomib era (1991-2002) and post-bortezomib era (2004-2011). The survival rate accompanied standard errors and the statistical significance was defined as p value <0.05. Results: The database comprised of 57,328 patients. The RS have improved significantly during post-bortezomib era in all cohorts under consideration. There was no significant difference in survival rate between male and female and between the African American and Caucasian. However, the relative survival was much better with the young adult (20-59 years) as compared to adult ≥60 years. The table detailing the relative survival is given below. Conclusion: The Primary treatment protocols for Multiple Myeloma have changed dramatically since the approval of Bortezomib in 2003. Other novel agents introduced in the last decade include thalidomide, Lenalidomide and liposomal doxorubicin that are used in conjunction with Bortezomib. Survival trends continue to improve and we believe this modest improvement in survival rate is mainly due to the introduction of Bortezomib and other novel agents. The next challenge is to find new drugs which would prevent relapses and further prolong survival. Abstract 2639. Table.Study armSubclass of cohortsPre-bortezomib era (1991-2002)Post- bortezomib era (2004-2011)Z scoreP ValueNRS (%)Relative Standard Error (SE) (%)NRS (%)Relative Standard Error (SE) (%) GenderMale13,06634.60.517,76546.10.615.904<0.0001Female11,58032.10.514,91743.70.614.765<0.0001 RaceCaucasian18,83632.90.423,98145.00.519.259<0.0001African American4,27434.70.86,39145.10.98.488<0.0001 Age group20-596,35848.10.69,43960.20.712.920<0.0001>=6018,28827.80.423,24338.40.516.606<0.0001 Total: male and female: 1991-2002; 24,646, RS 33.4%; SE 0.3%; 2004-2011; 32,682, RS 45.0%, SE 0.4%; Z score 21.766, P value <0.0001. Disclosures No relevant conflicts of interest to declare.

scholarly journals Reinforcement of Tobacco Control and Reduction in Medical Utilization for Asthma in Taiwan: A Population-Based Study

2019 ◽  
Vol 16 (20) ◽  
pp. 3950
Author(s):  
Huang-Ju Liang ◽  
Ming-Jiuan Wu ◽  
Jih-Shuin Jerng ◽  
Chiang-Hsing Yang
Keyword(s):  
Subgroup Analysis ◽  
Population Based ◽  
Dust Storms ◽  
Medical Utilization ◽  
Smoking Ban ◽  
Utilization Rate ◽  
Research Database ◽  
Population Based Study ◽  
Male And Female ◽  
Prevention Act

Environmental air quality can affect asthma control and the development of overt asthmatic manifestations. In this population-based study, we investigated the effect of reinforcing a smoking ban in Taiwan through the enactment of the Tobacco Hazards and Prevention Act (THPA) on healthcare utilization rate by asthmatics. Analysis was performed based on data relevant to non-hospitalized asthmatic patients with insurance claims between 2005 and 2013 from the National Health Insurance Research Database of Taiwan, reported data on Asian dust storms, and penalty rates for violations of the tobacco ban. Poisson regression showed that the risk for outpatient visits for asthma was lower after enactment of the THPA (RR = 0.98, 95% CI = 0.98–0.99), with a yearly trend of a reduced risk (RR = 0.99, 95% CI = 0.99–1.00), also lower in geographic regions with medium (RR = 0.79, 95% CI = 0.79–0.80) and high (RR = 0.91, 95% CI = 0.91–0.92) penalty rates. Subgroup analysis showed that asthma visit rates were reduced in both male and female groups after the enactment of the THPA. The risk of an asthma ER visit was increased after the enactment of the amended THPA (RR = 1.07, 95% CI = 1.05–1.09), although the yearly trend was not significant (RR = 1.00, 95% CI = 1.00–1.00). The risk of emergency room visits for asthma was significantly reduced in regions with medium (RR = 0.68, 95% CI = 0.68–0.69) and high (RR = 0.75, 95% CI = 0.74–0.76) penalty rates. Subgroup analysis showed that the visit rates were similar in both male and female groups. The effectiveness of reinforcing the smoking ban warrants further policies aimed at further reducing passive smoking.

No differential overall or relative survival effect of rituximab in male and female patients with diffuse large B-cell lymphoma: a Danish population-based study of 3783 patients

2019 ◽  
Vol 60 (11) ◽  
pp. 2798-2801
Author(s):  
Lasse Hjort Jakobsen ◽  
Jorne Lionel Biccler ◽  
Peter de Nully Brown ◽  
Judit Mészáros Jørgensen ◽  
Pär Lars Josefsson ◽  
...  
Keyword(s):  
Cell Lymphoma ◽  
Relative Survival ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Danish Population ◽  
Population Based Study ◽  
Male And Female ◽  
Large B Cell Lymphoma ◽  
Survival Effect ◽  
Large B Cell

scholarly journals Cancer Risks in Vitiligo Patients: A Nationwide Population-Based Study in Taiwan

2018 ◽  
Vol 15 (9) ◽  
pp. 1847 ◽  
Author(s):  
Cheng-Yuan Li ◽  
Ying-Xiu Dai ◽  
Yi-Ju Chen ◽  
Szu-Ying Chu ◽  
Tzeng-Ji Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Thyroid Cancer ◽  
Autoimmune Disease ◽  
Population Based ◽  
Research Database ◽  
Population Based Study ◽  
Male And Female ◽  
Female Patients ◽  
Male Patients

Vitiligo is an autoimmune disease characterized by destruction of melanocytes and associated with other autoimmune disease. Whether the dysregulation of immune system enhances oncogenesis or not remains obscure. Until now, no nationwide population-based study has been conducted regarding this. As such, this paper aims to clarify cancer risk in vitiligo patients. A retrospective nationwide population-based cohort study between 2000 and 2010 was performed based on data from the National Health Insurance Research Database of Taiwan. Standardized incidence ratios (SIRs) of cancers were analyzed. Among the 12,391 vitiligo patients (5364 males and 7027 females) and 48,531.09 person-years of observation, a total of 345 cancers were identified. Significantly increased SIRs were observed for prostate cancer in male patients, thyroid cancer and breast cancer in female patients and bladder cancers in both male and female patients. Unfortunately, the low incidence rate of certain cancers limited the power of our statistical analyses. This study demonstrated the patterns of malignancies in vitiligo patients of Taiwan. Compared with the general population, male patients had higher risks of prostate cancer and female patients had higher risks of thyroid cancer and breast cancer. The risks of bladder cancer were also increased in both male and female patients.

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