{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T19:17:27Z","timestamp":1778181447564,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"vor","delay-in-days":82,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To better understand the impact of the otolaryngology\u2010specific workforce on the burden of related diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective analysis of existing workforce density data as compared with the incidence, mortality, and morbidity data for 4 otolaryngologic diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>An overall 138 countries with known otolaryngology\u2013head and neck surgery workforce and epidemiologic data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We obtained raw data on workforce estimates of ear, nose, and throat surgical specialists from the World Health Organization. Disease burdens for 4 conditions were estimated via 2 ratios, the mortality:incidence ratio (MIR) and YLD:incidence ratio (years lost to disability), as specified in the Global Burden of Disease database. These were correlated to country\u2010specific otolaryngologist density data in univariate and multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Increased density of the ear, nose, and throat workforce correlated with better outcomes for otolaryngologic\u2010treated surgical diseases. A 10% increase in otolaryngology workforce density was associated with a 0.27% reduction in YLD:incidence ratio for chronic otitis media, a 0.94% reduction in MIR for lip and oral cavity cancer, a 1.46% reduction in MIR for laryngeal cancer, and a 1.34% reduction in MIR for pharyngeal cancer (all <jats:italic>P<\/jats:italic> &lt;. 001)\u2014an effect that remained after adjustment for health systems factors for all conditions but chronic otitis media.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The density of the surgical workforce is assumed to affect disease outcomes, but ours is the first analysis to show that increased workforce density for a specific surgical specialty correlates with improved disease outcomes. While there is a consensus to increase access to health care providers, quantifying the effect on disease outcomes is an important metric for those performing health economics modeling, particularly where resources are limited.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2473974x221089840","type":"journal-article","created":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T18:24:04Z","timestamp":1648146244000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Density of Health Workforce Correlates to Disease Outcomes: Evidence From Global Data in Otolaryngology"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2247-8000","authenticated-orcid":false,"given":"Gaelen Britton","family":"Stanford\u2010Moore","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of California San Francisco San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Cahill","sequence":"additional","affiliation":[{"name":"Program in Global Surgery and Social Change Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankit","family":"Raj","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Research in Surgical Care Delivery in LMICs Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pacifique","family":"Irakoze","sequence":"additional","affiliation":[{"name":"Umwizero Polyclinic Hospital Bujumbura Burundi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blake","family":"Alkire","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmood F.","family":"Bhutta","sequence":"additional","affiliation":[{"name":"Brighton and Sussex Medical School Brighton UK"},{"name":"Department of Ear, Nose, and Throat University Hospitals Sussex West Sussex UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60160\u2010X"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20100261\u20106"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(15)70115\u20104"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(14)70384\u20105"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(15)60835\u20102"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20102324\u2010y"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819897265"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000001007"},{"key":"e_1_2_10_10_1","unstructured":"GHDx.Global Burden of Disease Study 2017 (GBD 2017) data resources. 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