Factors Affecting the Regional Inequalities in Pediatricians Workload and the Regional Disparities in Access to Pediatric Healthcare Service in Poland

Abstract

Objective: The decreasing number of physicians is a serious problem in Poland. The purpose of this study was to identify the principal factors that determine the differences in the workload distribution of pediatricians and access to the public pediatric healthcare service in Poland. Methods: Using a range of attributive variables such as population size, socio-economic status, and pediatric service supply, the numerical changes that occurred in the workload of pediatricians (2010 to 2017) in 16 provinces (voivodeships) throughout Poland were analysed. Principal component analysis on the standardized attributive variables of voivodeships was performed and multiple regressions were undertaken. The index of accessibility to pediatricians was determined and its spatial diversity examined. Results: A moderate variation of the pediatrician workload in the period of 2010 to 2017 was found and the clubs convergence of the investigated phenomenon was observed. We identified two principal components: one that reflected the level of socio-economic status and second reflected degree of urbanization. The first component scores was negatively correlated with the number of treated patients per pediatrician. The study confirmed positive correlation between index of accessibility to pediatricians and disposable income per capita (0.672, p=0.004) and negative one with the number of treated patients per pediatrician (-0.663, p=0.005). Conclusion: The regional diversity of pediatrician's workload is governed by the rules of club convergence. An insufficient number of physicians and their high workload may have a significant impact on the quality of treatment provided.