caa a22 4500 445797258 CHVBK 20180317145129.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s10620-010-1284-4 doi (NATIONALLICENCE)springer-10.1007/s10620-010-1284-4 Associations of Physician Supplies with Colon Cancer Care in Ontario and California, 1996 to 2006 [Elektronische Daten] [Kevin Gorey, Isaac Luginaah, Emma Bartfay, Karen Fung, Eric Holowaty, Frances Wright, Caroline Hamm, Sindu Kanjeekal, Madhan Balagurusamy] Background: This study examined the differential effects of physician supplies on colon cancer care in Ontario and California. The associations of physician supplies with colon cancer stage at diagnosis, receipt of surgery and adjuvant chemotherapy, and 5-year survival were observed within each country and compared between-country. Methods: Random samples of Ontario and California cancer registries provided 2,461 and 2,200 colon cancer cases that were diagnosed between 1996 and 2000, and followed until 2006. Both registries included data on the stage of disease at the time of diagnosis, receipt of cancer-directed surgery, receipt of adjuvant chemotherapy, and survival. Census tract-level data on low-income prevalence were, respectively, taken from 2001 and 2000 Canadian and United States population censuses. County-level primary care physician and gastroenterologist densities were computed for the same years. Results: Significant income-adjusted, gastroenterologist density threshold effects (2.0 or more vs. less than 2.0 per 100,000 inhabitants) were observed for early diagnosis (OR=1.57) and 5-year survival (OR=1.63) in Ontario, but not in California. Significant incremental threshold effects of primary care physician densities on chemotherapy receipt (8.0 and 9.0 or more per 10,000 inhabitants, respective ORs of 1.79 and 2.37) were also only observed in Ontario. Conclusions: These colon cancer care findings support the theory that while personal economic resources are more predictive in America, community-level resources such as physician supplies are more predictive of health care access and effectiveness in Canada. Springer Science+Business Media, LLC, 2010 Physician supply nationallicence Primary care nationallicence Gastroenterology nationallicence Colon cancer nationallicence Canada nationallicence USA nationallicence Gorey Kevin School of Social Work, University of Windsor, 401 Sunset Avenue, N9B 3P4, Windsor, ON, Canada aut Luginaah Isaac Department of Geography, University of Western Ontario, London, ON, Canada aut Bartfay Emma Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada aut Fung Karen Department of Mathematics and Statistics, University of Windsor, Windsor, ON, Canada aut Holowaty Eric Population Studies and Surveillance, Cancer Care Ontario, Toronto, ON, Canada aut Wright Frances Department of Surgery and Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada aut Hamm Caroline Clinical Trials and Research, Windsor Regional Cancer Center, Windsor, ON, Canada aut Kanjeekal Sindu Medical Oncology Department, Windsor Regional Cancer Center, Windsor, ON, Canada aut Balagurusamy Madhan Department of Mathematics and Statistics, University of Windsor, Windsor, ON, Canada aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/2(2011-02-01), 523-531 0163-2116 56:2<523 2011 56 10620 https://doi.org/10.1007/s10620-010-1284-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1284-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gorey Kevin School of Social Work, University of Windsor, 401 Sunset Avenue, N9B 3P4, Windsor, ON, Canada aut NATIONALLICENCE 700 1- Luginaah Isaac Department of Geography, University of Western Ontario, London, ON, Canada aut NATIONALLICENCE 700 1- Bartfay Emma Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada aut NATIONALLICENCE 700 1- Fung Karen Department of Mathematics and Statistics, University of Windsor, Windsor, ON, Canada aut NATIONALLICENCE 700 1- Holowaty Eric Population Studies and Surveillance, Cancer Care Ontario, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Wright Frances Department of Surgery and Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Hamm Caroline Clinical Trials and Research, Windsor Regional Cancer Center, Windsor, ON, Canada aut NATIONALLICENCE 700 1- Kanjeekal Sindu Medical Oncology Department, Windsor Regional Cancer Center, Windsor, ON, Canada aut NATIONALLICENCE 700 1- Balagurusamy Madhan Department of Mathematics and Statistics, University of Windsor, Windsor, ON, Canada aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/2(2011-02-01), 523-531 0163-2116 56:2<523 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer