Impact of general practitioners and specialists on mortality: a longitudinal study.

BACKGROUND: Evaluating health outcomes is essential for identifying health-related needs; ensuring an adequate number of physicians, their specialties, and their distribution; and formulating new health policies. The causes of death are significant health outcomes. Moreover, there is a strong correlation between a region’s developmental level and cause-specific deaths. This study analysed data from Turkey between 2010 and 2014 to explore the relationship between the number of cases of cause-specific mortality in individuals aged 45 years and older, infant mortality rates (IMR) and total mortality rates in the 15–44 years age group and the availability of general practitioners (GPs) and specialists, aiming to understand the impact of physician numbers on mortality rates. METHODS: This is a retrospective longitudinal study that encompasses an analysis of all 81 provinces in Turkey. The dependent variable is the number of cause-specific deaths, while the independent variables include the number of physicians by specialty, income level, number of hospital beds, and number of high school graduates. Linear regression models with random effects were utilized for statistical analysis, facilitating the calculation of coefficients for each province. RESULTS: The results revealed a significant negative correlation between the number of GPs and mortality due to ischaemic heart disease (IHD), central nervous system diseases (CNSD), malignancies, diabetes, and IMR. As the number of GPs increased, the rates of these mortalities decreased. The availability of cardiologists was negatively correlated with mortality from IHD, and the availability of neurologists was negatively correlated with mortality from CNSD. The overall specialist ratio was negatively correlated with the mortality rate in individuals aged 15–44 years. The number of deaths from chronic diseases was higher in the more developed western regions of the country. In contrast, mortality rates among those aged 15–44 years and infant mortality rates were higher in the eastern provinces. CONCLUSION: The number of GPs significantly impacts the reduction in the number of deaths from chronic diseases and IMR. Strengthening primary care services by increasing the number of GPs who can reach a wider population effectively and cost-efficiently will be a key factor in improving public health.