Hepatitis B and C are diseases leading to a significant financial impact on health care systems in the United States. (US). There are close to 1 million and 3.5 million chronic carriers of Hepatitis B and C respectively in the US. Hepatitis B is associated with approximately $1.5 billion in health care expenditure through hospitalizations. In the case of Hepatitis C, it is estimated that a person infected will result in a monthly cost of $691 which doubles to $1,227 for people with compensated (stable) cirrhosis, $3,682 for decompensate cirrhosis. Studies have speculated that the total cost of hepatitis is $6.5 billion annually in the US.
The location of current Infectious Disease (ID) and Gastroenterology (GI) fellowships was obtained from the NRMP public data. These were mapped using Google fusion tables and the results compared to CDC databases, mainly: New Hepatitis B and C diagnosis and prevalence rates of chronic Hepatitis C.
A total 147 fellowship programs were identified in Infectious Disease and Gastroenterology. New diagnoses of Hepatitis B were concentrated in the Midwestern, Southern and Western regions of the country, whereas new diagnoses of Hepatitis C were concentrated in the Northern, Southern and Western regions of the country. These locations correlated with fewer fellowships, except along the west coast. The ID and GI fellowship training programs have a heavy concentration in the Eastern belt of the country. This eastern concentration interestingly correlated with increased prevalence of Hepatitis C in the New York state area. Studies have also shown in the past that physicians tend to practice in geographical locations where they completed their fellowship training.
The use of this novel social network mapping approach to assess the Infectious Disease and Gastroenterology physician workforce has the potential of providing real time data regarding their geographical spread. The discrepancies between supply and demand could be addressed by targeted rebalancing interventions that may include additional fellowship spots in ‘underserved’ areas as well as financial and practice incentives.
A. Treitman, None