Simple Thematic Mapping

Pisati, Maurizio

doi:10.1177/1536867x0400400401

Cited by 34 publications

(32 citation statements)

References 2 publications

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“…( 5 ) NAS incidence rates were calculated by division (9 overall: New England, Mid-Atlantic, East North Central, West North Central, South Atlantic, East South Central, West South Central, Mountain, Pacific) for 2012. Maps were generated to evaluate geographic variation of NAS using the spmap command( 19 ) in Stata, with map data obtained from the National Oceanic and Atmospheric Administration. ( 20 ) Throughout our analysis, all testing was 2-sided, with data reported with standard errors or 95% confidence intervals.…”

Section: Methodsmentioning

confidence: 99%

Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012

et al. 2015

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Objective Neonatal abstinence syndrome (NAS), a postnatal opioid withdrawal syndrome, increased 3-fold from 2000 to 2009. Since 2009, opioid pain reliever prescriptions and complications increased markedly throughout the US. Understanding recent changes in NAS and its geographic variability would inform state and local governments in targeting public health responses. Study Design We utilized diagnostic and demographic data for hospital discharges from 2009 to 2012 from the Kids’ Inpatient Database and the Nationwide Inpatient Sample. NAS-associated diagnoses were identified utilizing ICD-9-CM codes. All analyses were conducted with nationally weighted data. Expenditure data were adjusted to 2012 US dollars. Between-year differences were determined utilizing least squares regression. Results From 2009 to 2012, NAS incidence increased nationally from 3.4 (95%CI: 3.2-3.6) to 5.8 (95%CI 5.5-6.1) per 1,000 hospital births, reaching a total of 21,732 infants with the diagnosis. Aggregate hospital charges for NAS increased from $732M to $1.5B (p<0.001), with 81% attributed to state Medicaid programs in 2012. NAS incidence varied by geographic Census division, with the highest incidence rate (per 1000 hospital births) of 16.2 (95%CI 12.4-18.9) in the East South Central Division (KY, TN, MS, AL) and the lowest in West South Central Division 2.6 (95%CI 2.3-2.9; [OK, TX, AR, LA]). Conclusion NAS incidence and hospital charges grew substantially during our study period. This costly public health problem merits a public health approach to alleviate harm to women and children. States, particularly in areas of the country most affected by the syndrome, must continue to pursue primary prevention strategies to limit the effects of opioid pain reliever misuse.

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Section: Methodsmentioning

confidence: 99%

Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012

et al. 2015

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“…Whenever medians are reported, we also report the 25th and 75th centiles. Spatial maps were plotted using the spmap command [21]. An alpha level of 5% was used throughout.…”

Section: Methodsmentioning

confidence: 99%

The potential impact of Brexit and immigration policies on the GP workforce in England: a cross-sectional observational study of GP qualification region and the characteristics of the areas and population they served in September 2016

Esmail

Panagioti

Kontopantelis

2017

BMC Med

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BackgroundThe UK is dependent on international doctors, with a greater proportion of non-UK qualified doctors working in its universal health care system than in any other European country, except Ireland and Norway. The terms of the UK exit from the European Union can reduce the ability of European Economic Area (EEA) qualified doctors to work in the UK, while new visa requirements will significantly restrict the influx of non-EEA doctors. We aimed to explore the implications of policy restrictions on immigration, by regionally and spatially describing the characteristics of general practitioners (GPs) by region of medical qualification and the characteristics of the populations they serve.MethodsThis is a cross-sectional study on 37,792 of 41,865 GPs in England, as of 30 September 2016. The study involved age, sex, full-time equivalent (FTE), country and region of qualification and geography (organisational regions) of individual GPs. Additionally at the practice and geography levels, we studied patient list size by age groups, average patient location deprivation, the overall morbidity as measured by the Quality and Outcomes Framework (QOF) and the average payment made to primary care per patient.ResultsNon-UK qualified GPs comprised 21.1% of the total numbers of GPs, with the largest percentage observed in East England (29.8%). Compared to UK qualified GPs, EEA and elsewhere qualified GPs had higher FTE (medians were 0.80, 0.89 and 0.93, respectively) and worked in practices with higher median patient location deprivation (18.3, 22.5 and 25.2, respectively). Practices with high percentages of EEA and elsewhere qualified GPs served patients who resided in more deprived areas, had lower GP-to-patient ratios and lower GP-to-cumulative QOF register ratios. A decrease in pay as the percentage of elsewhere qualified GPs increased was observed; a 10% increase in elsewhere qualified GPs was linked to a £1 decrease (95% confidence interval 0.5–1.4) in average pay per patient.ConclusionsA large percentage of the UK general practice workforce consists of non-UK qualified GPs who work longer hours, are older and serve a larger number of patients in more deprived areas. Following Brexit, difficulties in replacing this valuable workforce will primarily threaten the care delivery in deprived areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0953-y) contains supplementary material, which is available to authorized users.

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“…A municipality with a high Moran’s I statistic indicates that its incidence proportion values are close in magnitude to those of the neighbouring municipality. We used the tool to draw cluster maps visualising what is also called “hot spots” (correlation of municipalities with high incidence proportion values) and “cold spots” (correlation of municipalities with low incidence proportion values) [ 45 ].…”

Section: Methodsmentioning

confidence: 99%

Geographic analysis of the variation in the incidence of ADHD in a country with free access to healthcare: a Danish cohort study

et al. 2015

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BackgroundThe prevalence of citizens diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) has risen dramatically over the past decades in many countries, however, with large variations. Countries such as Denmark with centrally organized well fare systems, free access to health services and individual tracking based on unique personal identification may in particular contribute to our understanding of the reasons for this increase. Based on Danish registers we aimed to examine the geographical patterns of the distribution of ADHD diagnosis and medication use and explore the association with access to diagnostic services, diagnostic culture, neighbourhood socioeconomic status and municipal spending on health care for children.MethodsWe combined information on registered diagnosis of ICD-10 Hyperkinetic Disorder and ADHD medication use in a Danish register-based cohort of children born between 1990 and 2000. We mapped incidence proportions of diagnoses and medication use within the 98 Danish Municipalities. Global and local clustering of ADHD was identified using spatial analysis. Information on contextual factors in the municipalities was obtained from national registers. The associations between the incidence of ADHD and contextual factors were analysed using Bayesian spatial regression models.ResultsWe found a considerable variation in the incidence of ADHD across the municipalities. Significant clustering of both high and low incidence of ADHD was identified and mapped using the local Moran’s I. Clustering of low incidence of diagnosis and medication use was observed in less populated areas with limited diagnostic resources and in contrast clustering of high incidence in densely populated areas and greater diagnostic resources. When considering the spatial autocorrelation between neighbouring municipalities, no significant associations were found between ADHD and access to diagnostic services, different diagnostic culture, socioeconomic status at municipality level or the municipal spending on health care for children.ConclusionsA large geographical variation of ADHD in the municipalities was observed despite tax-financed and free access to healthcare. Although not statistically significant, results indicate that accessibility to diagnostic resources might explain some of the variation in ADHD incidence. In contrast to US studies the observed variation was not statistically associated to contextual factors in terms of SES, municipal spending on health care for children or differences in diagnostic practices.

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Simple Thematic Mapping

Cited by 34 publications

References 2 publications

Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012

Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012

The potential impact of Brexit and immigration policies on the GP workforce in England: a cross-sectional observational study of GP qualification region and the characteristics of the areas and population they served in September 2016

Geographic analysis of the variation in the incidence of ADHD in a country with free access to healthcare: a Danish cohort study

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