Background: We evaluated geographic patterns for immediate and delayed breast reconstruction (IBR, DBR) in Ontario. The influence of plastic surgeon availability on rates and service provision was determined.
Methods: We examined IBR and DBR from 2002 through 2011 across Ontario counties. Regional availability of plastic surgeons was described. Geographic patterns were examined using funnel plots, random-effects models and migration indices.
Results: Over ½ Ontario counties have no plastic surgeons. IBR ranged from 0 to 21.5% across counties and differences in plastic surgeon availability explained 41% of variation (p < 0.0001). For DBR there was less variation. 5/45 counties performed ¾ of BR, however rates among local residents were not highest.
Interpretation: Nearly 1/3 of the population has limited access to plastic surgeons, contributing to low rates of BR. Geographic access is a major determinant of IBR but is less important for DBR, however service provision for both was highly regionalized.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/43301 |
| Date | 09 December 2013 |
| Creators | Platt, Jennica |
| Contributors | Baxter, Nancy, Zhong, Toni |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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