Author:
Žarković Miloš,Attanasio Roberto,Nagy Endre V.,Negro Roberto,Papini Enrico,Perros Petros,Cohen Chagit Adler,Akarsu Ersin,Alevizaki Maria,Ayvaz Göksun,Bednarczuk Tomasz,Berta Eszter,Bodor Miklos,Borissova Anna Maria,Boyanov Mihail,Buffet Camille,Burlacu Maria-Cristina,Ćirić Jasmina,Díez Juan J.,Dobnig Harald,Fadeyev Valentin,Field Benjamin C. T.,Fliers Eric,Frølich Jacob Stampe,Führer Dagmar,Galofré Juan Carlos,Hakala Tommi,Jiskra Jan,Kopp Peter,Krebs Michael,Kršek Michal,Kužma Martin,Lantz Mikael,Lazúrová Ivica,Leenhardt Laurence,Luchytskiy Vitaliy,McGowan Anne,Melo Miguel,Metso Saara,Moran Carla,Morgunova Tatyana,Mykola Tronko,Beleslin Biljana Nedeljković,Niculescu Dan Alexandru,Perić Božidar,Planck Tereza,Poiana Catalina,Puga Francisca Marques,Robenshtok Eyal,Rosselet Patrick,Ruchala Marek,Riis Kamilla Ryom,Shepelkevich Alla,Unuane David,Vardarli Irfan,Visser W. Edward,Vrionidou Andromachi,Younes Younes R.,Yurenya Elena,Hegedüs Laszlo
Abstract
IntroductionThyroid specialists influence how hypothyroid patients are treated, including patients managed in primary care. Given that physician characteristics influence patient care, this study aimed to explore thyroid specialist profiles and associations with geo-economic factors.MethodsThyroid specialists from 28 countries were invited to respond to a questionnaire, Treatment of Hypothyroidism in Europe by Specialists: an International Survey (THESIS). Geographic regions were defined according to the United Nations Statistics Division. The national economic status was estimated using World Bank data on the gross national income per capita (GNI per capita).Results5,695 valid responses were received (response rate 33·0%). The mean age was 49 years, and 65·0% were female. The proportion of female respondents was lowest in Northern (45·6%) and highest in Eastern Europe (77·2%) (p <0·001). Respondent work volume, university affiliation and private practice differed significantly between countries (p<0·001). Age and GNI per capita were correlated inversely with the proportion of female respondents (p<0·01). GNI per capita was inversely related to the proportion of respondents working exclusively in private practice (p<0·011) and the proportion of respondents who treated >100 patients annually (p<0·01).DiscussionTHESIS has demonstrated differences in characteristics of thyroid specialists at national and regional levels, strongly associated with GNI per capita. Hypothyroid patients in middle-income countries are more likely to encounter female thyroid specialists working in private practice, with a high workload, compared to high-income countries. Whether these differences influence the quality of care and patient satisfaction is unknown, but merits further study.
Subject
Endocrinology, Diabetes and Metabolism