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The Impact of Pediatrician Supply on Child Health Outcomes: Longitudinal Evidence from Japan.

ABSTRACT: To investigate the effect of pediatrician supply on under-5 mortality over the period 2000-2010.Multiple publicly available data sources were used.Japan's 366 "Secondary Tier of Medical Care Units" (STMCU) were used as study units. To evaluate the association between under-5 mortality and pediatrician supply, we explored time and area fixed-effects Poisson regression model. The following factors were introduced into the models as time-varying controls: (1) number of physicians other than pediatricians per total population except for under-5-year-old population, and (2) income per total population by year and STMCU. Extensive sensitivity analyses were conducted to assess robustness of results.Pediatrician density was inversely associated with under-5 mortality. We estimated that a unit increase in pediatrician density was associated with a 7 percent (95 percent CI: 2-12 percent) reduction in the child mortality rate after adjustment for all other variables. The results were consistent and robust across all specifications tested.The results suggest that increasing human health resources can have positive effects on child health, even in settings where child mortality of less than 5 per 1,000 has been achieved.

SUBMITTER: Sakai R

PROVIDER: S-EPMC4799901 | biostudies-other | 2016 Apr

REPOSITORIES: biostudies-other

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The Impact of Pediatrician Supply on Child Health Outcomes: Longitudinal Evidence from Japan.

Sakai Rie R Fink Günther G Kumamaru Hiraku H Kawachi Ichiro I

Health services research 20150901 2

<h4>Objective</h4>To investigate the effect of pediatrician supply on under-5 mortality over the period 2000-2010.<h4>Data sources</h4>Multiple publicly available data sources were used.<h4>Study design</h4>Japan's 366 "Secondary Tier of Medical Care Units" (STMCU) were used as study units. To evaluate the association between under-5 mortality and pediatrician supply, we explored time and area fixed-effects Poisson regression model. The following factors were introduced into the models as time-v ...[more]

PMID: 26331211

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Project description:This study aimed to investigate longitudinal relations between leisure and social activities and mental health status, considering the presence or absence of other persons in the activity as an additional variable, among middle-aged adults in Japan. This study used nationally representative data in Japan with a five-year follow-up period.This study focused on 16,642 middle-aged adults, age 50-59 at baseline, from a population-based, six-year panel survey conducted by the Japanese Ministry of Health, Labour and Welfare. To investigate the relations between two leisure activities ('hobbies or cultural activities' and 'exercise or sports') and four social activities ('community events', 'support for children', 'support for elderly individuals' and 'other social activities') at baseline and mental health status at follow-up, multiple logistic regression analysis was used. We also used multiple logistic regression analysis to investigate the association between ways of participating in these activities ('by oneself', 'with others', or 'both' (both 'by oneself' and 'with others')) at baseline and mental health status at follow-up.Involvement in both leisure activity categories, but not in social activities, was significantly and positively related to mental health status in both men and women. Furthermore, in men, both 'hobbies or cultural activities' and 'exercise or sports' were significantly related to mental health status only when conducted 'with others'. In women, the effects of 'hobbies or cultural activities' on mental health status were no differences regardless of the ways of participating, while the result of 'exercise or sports' was same as that in men.Leisure activities appear to benefit mental health status among this age group, whereas specific social activities do not. Moreover, participation in leisure activities would be effective especially if others are present. These findings should be useful for preventing the deterioration of mental health status in middle-aged adults in Japan.

Project description:Background:Over the last two decades, the Mexican government has released several efforts to achieve universal health coverage (UHC), based on the principles of fairness and social protection, to reduce the inequities in utilization, access, and quality of care existing in the health system. Two of the most important social public policies that have targeted the population without access to social security include the 1997 conditional cash transfers (CCT) program known as Prospera (formerly Oportunidades or Progresa) and the Seguro Popular de Salud (SPS by its Spanish initials), launched in 2003. These two programs, so far, have survived changes in the federal administrations being the most longstanding social programs targeting poor (or unprotected) populations ever in the history of modern Mexico. We tested the existence of positive synergies between demand-side (or CCT-Prospera) and supply-side (or Seguro Popular de Salud, SPS) social programs in the achievement of effective coverage (EC) of maternal-child health interventions in Mexico. Methods:We performed a retrospective-cohort analysis to 6413 women aged 12-49 years who participated in a probabilistic survey conducted in 2012. We calculated EC as the product of three indexes: need, utilization and quality of health care. Correlates of EC were identified estimating a logistic regression model. We also presented adjusted EC by specific women groups. Results:EC among beneficiaries of both programs was similar to estimates in Social Security affiliates (54%). For those not affiliated to any of the programs or those who received benefits for only one of them, the EC was 47.6% and 45.5% respectively. Adjusted estimates of EC suggest that overall, having both programs (Prospera?+?SPS) has a positive effect on maternal and child care coverage, which makes the observed differences in EC not statistically significant between those affiliated to both programs in comparison with the observed in the population with social security. Conclusions:Results support positive synergies between Prospera and SPS in the reduction of the gaps in EC. The most vulnerable population groups need to be reached by the combination of these programs so that public health efforts translate into greater EC of maternal health services and better maternal-child outcomes.

Dataset Information

The Impact of Pediatrician Supply on Child Health Outcomes: Longitudinal Evidence from Japan.

Publications

The Impact of Pediatrician Supply on Child Health Outcomes: Longitudinal Evidence from Japan.

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