To investigate trends in upper gastrointestinal bleeding (UGIB) mortality across varying demographic factors (age, sex, race) and geographic factors (state and county levels) and to determine the impact of primary care provider density (PCPD) and gastrointestinal physician density (GIPD) on UGIB mortality rates in the United States.
Approach:
Key Findings:
Overall CMR for UGIB was 12.1 per 100,000 population and AAMRs were 11.0 per 100,000 population from 1999 to 2023.
Mortality rates increased from 2018 to 2021 (APC: +9.05) and decreased from 2021 to 2023 (APC: -7.93).
CMRs were highest among older age groups, American Indian or Alaska Native populations, and rural communities.
Men had higher AAMRs than women.
GIPD was significantly associated with CMRs, with lower GIPD linked to higher UGIB mortality (OR: 1.121, p < 0.001).
PCPD showed no significant association with CMRs (p = 0.120).
Geographical patterns of UGIB mortality were identified, with certain states exhibiting higher rates.
Interpretation:
GIPD, rather than PCPD, was significantly associated with higher CMRs for UGIB.
Limitations:
The study relied on publicly available data, which may have limitations in completeness and accuracy.
Geographical patterns of UGIB mortality were not explored in depth, limiting the understanding of regional disparities.
Conclusion:
GIPD is a critical factor influencing UGIB mortality rates, highlighting the need for increased availability of gastrointestinal specialists.
