Journal article
Impact of county rurality and urologist density on urological cancer mortality in illinois
The Journal of urology, Vol.193(5), pp.1608-1614
05/2015
DOI: 10.1016/j.juro.2014.11.100
PMID: 25498569
Abstract
The urology work force is contracting at a time when service demand is increasing due to demographic changes, especially in rural areas. We investigated the impact of rural status and urologist density on kidney and renal pelvis, bladder and prostate cancer mortality at the county level in Illinois.
We stratified the 102 Illinois counties by 2003 RUCCs as urban (36, RUCCs 1 to 3) and rural (66, RUCCs 4 to 9). Area Health Resource Files were used for county demographic data and urologist density. County level age adjusted mortality rates from 1990 to 2010 were derived from National Center for Health Statistics data using SEER*Stat. We examined the associations of urological cancer mortality rates with rural status and urologist density.
Average urologist density significantly differed between rural and urban counties (1.9 vs 3.4/100,000 population, p < 0.01). The kidney and renal pelvis cancer mortality rate in rural counties was higher than in urban counties while that of prostate cancer was lower (4.9 vs 4.3 and 28.7 vs 32.2/100,000 population, respectively, each p < 0.01). Urologist density correlated with the mortality rate of kidney and renal pelvis cancer (Pearson coefficient -0.33, p < 0.01) but not with the bladder or prostate cancer mortality rate. Multiple regression analysis revealed that rurality and lower urologist density (p = 0.01 and < 0.05) were significantly associated with higher kidney and renal pelvis cancer mortality.
Rural residence and low urologist density were associated with increased kidney and renal pelvis cancer mortality on the county level in Illinois. Further expansion and testing of evidence-based telemedicine is warranted because remote technical consultation is now technologically feasible, effective, inexpensive and satisfactory to patients.
Details
- Title: Subtitle
- Impact of county rurality and urologist density on urological cancer mortality in illinois
- Creators
- Thomas P Frye - Division of Urology and Center for Clinical Research (WEZ, WDJ, DID, GSM), Southern Illinois University School of Medicine, Springfield, IllinoisDaniel J Sadowski - Division of Urology and Center for Clinical Research (WEZ, WDJ, DID, GSM), Southern Illinois University School of Medicine, Springfield, IllinoisWhitney E Zahnd - Division of Urology and Center for Clinical Research (WEZ, WDJ, DID, GSM), Southern Illinois University School of Medicine, Springfield, IllinoisWiley D Jenkins - Division of Urology and Center for Clinical Research (WEZ, WDJ, DID, GSM), Southern Illinois University School of Medicine, Springfield, IllinoisDanuta I Dynda - Division of Urology and Center for Clinical Research (WEZ, WDJ, DID, GSM), Southern Illinois University School of Medicine, Springfield, IllinoisGeorgia S Mueller - Division of Urology and Center for Clinical Research (WEZ, WDJ, DID, GSM), Southern Illinois University School of Medicine, Springfield, IllinoisShaheen R Alanee - Division of Urology and Center for Clinical Research (WEZ, WDJ, DID, GSM), Southern Illinois University School of Medicine, Springfield, IllinoisKevin T McVary - Division of Urology and Center for Clinical Research (WEZ, WDJ, DID, GSM), Southern Illinois University School of Medicine, Springfield, Illinois. Electronic address: kmcvary@siumed.edu
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.193(5), pp.1608-1614
- DOI
- 10.1016/j.juro.2014.11.100
- PMID
- 25498569
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 05/2015
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984214815402771
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