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The Impact of Pediatrician Supply on Child Health Outcomes: Longitudinal Evidence from Japan

Keywords: Human resources for health; pediatrician supply; under-5 mortality; Japan.

Objective: To investigate the effect of pediatrician supply on under-5 mortality over the period 2000–2010.

Data Sources: Multiple publicly available data sources were used.

Study Design: Japan's 366 “Secondary Tier of Medical Care Units” (STMCU) were used as study units. To evaluate the association between under-5 mortality and pediatrician supply, we explored time and area fixed-effects Poisson regression model. The following factors were introduced into the models as time-varying controls: (1) number of physicians other than pediatricians per total population except for under-5-year-old population, and (2) income per total population by year and STMCU. Extensive sensitivity analyses were conducted to assess robustness of results.

Principal Findings: Pediatrician density was inversely associated with under-5 mortality. We estimated that a unit increase in pediatrician density was associated with a 7 percent (95 percent CI: 2–12 percent) reduction in the child mortality rate after adjustment for all other variables. The results were consistent and robust across all specifications tested.

Conclusions: The results suggest that increasing human health resources can have positive effects on child health, even in settings where child mortality of less than 5 per 1,000 has been achieved.

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