Sepsis is associated with an increased risk of complications and a significant financial impact on healthcare systems in the United States (US). A regional state-by-state approach to mapping the incidence of this disease with availibility of physicians, may provide additional information and insight on how to manage it. Over the past decade, reimbursement and lack of specialty-trained physicians have been cited as challenges in the battle against sepsis.
We conducted a descriptive analysis using mortality data from the National Center for Health Statistics'(NCHS), Compressed Mortality File (CMF), which contains descriptive data on the age, race, sex, year and causes of all deaths in the US. We defined sepsis death as death attributed to an infection. In addition, the location of current Critical Care fellowships was obtained from the National Residency Matching Program (NRMP) public data. We mapped this data using Google fusion tables and studied them in relation to deaths attributed to infection in the continental US, after running algorithms through the NCHS software, selecting deaths from infections, in age groups 20 years and older, in all races, and both sexes, with state wise charting of the data.
A total of 150 Critical Care fellowship programs were identified Our results indicate that Critical Care fellowship programs tend to be more concentrated in the Northeast and metropolitan areas in the Western regions of the US, in a similar pattern noted in other specialties. Survival rates for sepsis were also noted to be higher in these locations. Several previous studies indicate that physicians often tend to practice in geographic areas close to their training sites. A cluster extending from the Southeastern to the mid-Atlantic US encompassed states with the highest sepsis mortality, whereas, the west coast had a significantly lower crude mortality rate as compared to the south eastern regions.
The use of this novel mapping approach to assess the Critical Care physician workforce has the potential of providing data regarding their geographical spread. The discrepancies between supply and demand could be addressed by targeted rebalancing interventions that may include additional critical care fellowship spots in ‘underserved’ areas as well as financial and practice incentives.
A. Krikorian, None
A. Treitman, None
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