Keywords: Physicians, Colonoscopy, Cancer, Health Services Accessibility, Health Manpower, Density
Our objective was to test a new method of calculating physician density by incorporating weights that consider physician procedure volume and “sufficiency”, the number of procedures to maintain high quality. Data sources included the 2014 Medicare Provider Utilization and Payment Database and the NCI State Cancer Profile Database. Volume-weighted physician density scores at the state and county levels were created, accounting for: 1) the physician’s annual colonoscopy volume and 2) whether the physician could be considered to be performing a “sufficient” number of procedures to maintain high quality (i.e., = 100 procedures per year). We compared volume-weighted vs. traditional density, and examined the correlation with colorectal cancer screening, incidence, and mortality rates. The difference between volume-weighted and traditional density scores was particularly large in parts of the West and Midwest, and most similar in the Northeast. Although weak, most correlations were strongest for volume-weighted density. In summary, volume-weighted density portrays a more realistic picture of physician supply and has a stronger correlation with population health outcomes.