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Distribution of Pediatric Subspecialists Still Uneven

Study suggests long-term increases in supply may improve spread

WEDNESDAY, Dec. 9 (HealthDay News) -- There was an increase in the number of pediatric subspecialists from 2003 to 2006, but this did not lead to significant improvements in the distribution of subspecialists across hospital referral regions in the short term, according to a study in the December issue of the Archives of Pediatrics & Adolescent Medicine.

The late Michelle L. Mayer, Ph.D., and colleagues at the University of North Carolina at Chapel Hill analyzed 2003 to 2006 data from the American Board of Pediatrics to determine whether newly certified pediatricians were more likely to work where there were no certified subspecialists, and to examine changes in the number and distribution of subspecialists across hospital referral regions.

The researchers found that supply increased in 10 pediatric subspecialties, while decreasing in five; in eight out of the 15 subspecialties, newly certified physicians were more likely than their previously certified counterparts to practice in a hospital referral region without an existing subspecialist. Distribution of subspecialists reflected the increase or decrease of supply, with wider distribution of those subspecialties with increased supply, the investigators discovered; but, for some subspecialties, increased supply reinforced existing uneven distribution.

"Our findings suggest that increases in supply alone, in the short run, will not lead to improvements in the distribution of pediatric subspecialists," the authors write. "Financial and other incentives to locate in less desirable areas may be needed."

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