Geographic variations in specialty distribution and specialty-related mortality.

Using data from the Centers for Disease Control and Centers for Medicare and Medicaid Services, we analyzed the relationship between specialty physician location and specialty-specific mortality rates for diagnoses where access to specialty expertise could plausibly reduce death rates. After adjustment for demographic and health indicators, counties with the highest quartile specialty physician density had lower mortality rates compared to counties with the lowest quartile. The observed association in endocrinology, infectious disease, and neurology was 10.7, 2.9 and 7.2 fewer deaths per 100,000 residents, respectively. There is an inverse correlation between the distribution of select specialties and population-level mortality.