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Nevertheless, it remains a possibility that PM2.5 levels could be associated with other aspects that predict a higher rate of coding diabetes as the underlying mortality cause (e.g., regional practice style, provincial reimbursement by diagnosis, density of specialist type, training in death certificate completion) that were not apparent in our main or subgroup analyses.
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A high density of specialists in the ambulatory sector indicates high competition between the physicians.
Conversely, a high density of specialists allows the individual physician to spend more time with each patient.
A low density of specialists in the ambulatory care could increase the number of patients an individual doctor has to treat in a given period of time and consequently less diseases can be diagnosed due to less thorough examinations.
We investigated the effects of the density of specialists and of the area-level percentage of highly educated individuals on the odds of consulting a specialist, and examined whether these variables could explain the observed urban/rural contrast in utilization of specialty care.
In metropolitan areas the density of specialists is nowadays already much higher than for PCPs.
In the model for specialists, the estimated log density of specialists is higher than the estimate for GP density.
Inverse patterns were seen for the association between the GP-consultation rate and the regional density of specialists.
Compared to the number of GPs, the density of specialists is generally more strongly associated with the population density and other variables describing an urbanized district.
Thus, the hypothesis that higher rates of procedures are associated with the "enthusiasm" and density of specialists who perform those procedures16 did appear to have some merit.
The utilization of specialist services per capita (AZS) is linked with a higher density of specialists (SPZ), a higher population density (POP), and a larger share of high deductibles (FRA).
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