Health Affairs

Posting date: March 15, 2005

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Health Affairs, 10.1377/hlthaff.w5.97
Copyright © 2005 by Project HOPE

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The Effects Of Specialist Supply On Populations' Health: Assessing The Evidence

Barbara Starfield ^1*, Leiyu Shi ², Atul Grover ³, James Macinko ⁴

¹ Barbara Starfield is University Distinguished Professor in the Johns Hopkins School of Public Health, Baltimore, Maryland.
² Leiyu Shi is an associate professor in the Johns Hopkins School of Public Health, Baltimore, Maryland.
³ Atul Grover is an instructor in the Johns Hopkins School of Public Health, Baltimore, Maryland.
⁴ James Macinko is an assistant professor of public health at New York University in New York City.

^*Corresponding author.

Abstract

Analyses at the county level show lower mortality rates where there are more primary care physicians, but this is not the case for specialist supply. These findings confirm those of previous studies at the state and other levels. Increasing the supply of specialists will not improve the United States' position in population health relative to other industrialized countries, and it is likely to lead to greater disparities in health status and outcomes. Adverse effects from inappropriate or unnecessary specialist use may be responsible for the absence of relationship between specialist supply and mortality.

Key Words: Access To Care, Consumer Issues, Health Promotion/Disease Prevention, Health Reform, International Issues, Physicians, Workforce Issues

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