Featured Research

from universities, journals, and other organizations

Higher levels of primary care physicians in area associated with favorable outcomes for patients

Date:
May 24, 2011
Source:
JAMA and Archives Journals
Summary:
Medicare beneficiaries residing in areas with higher levels of primary care physicians per population have modestly lower death rates and fewer preventable hospitalizations, according to a new study.

Medicare beneficiaries residing in areas with higher levels of primary care physicians per population have modestly lower death rates and fewer preventable hospitalizations, according to a study in the May 25 issue of JAMA.

Related Articles


"Strengthening the role of primary care is a key element in most proposals to improve the outcomes and efficiency of health care delivery in the United States. With the aging population and the waning interest in primary care by U.S. medical school graduates, some have projected a large shortage of general internists and family physicians to care for a growing number of elderly patients," according to background information in the article. "Despite a widespread interest in increasing the numbers of primary care physicians to improve care and to moderate costs, the relationship of the primary care physician workforce to patient-level outcomes remains poorly understood."

Chiang-Hua Chang, Ph.D., of Dartmouth Medical School, Hanover, N.H., and colleagues conducted a study to examine whether high levels of primary care physician workforce are associated with lower mortality, fewer ambulatory care sensitive condition (ACSC) hospitalizations, and lower spending in Medicare beneficiaries. ACSC hospitalizations are regarded as largely preventable admissions when adequate and timely ambulatory (outpatient) care is provided. The study consisted of an analysis of the outcomes of a 20 percent sample of fee-for-service Medicare beneficiaries age 65 years or older (n = 5,132,936) in 2007, and used 2 measures of adult primary care physicians (general internists and family physicians) across Primary Care Service Areas (n = 6,542): American Medical Association (AMA) Masterfile nonfederal, office-based physicians per total population; and full-time equivalents (FTEs), a workforce measure that is an estimate of the ambulatory clinical FTEs of primary care physicians, derived from Medicare office- and clinic-based claims of primary care physicians.

The researchers found marked variation in the primary care physician workforce across areas, but low correlation was observed between the 2 primary care workforce measures. After adjusting for certain patient and area variables, only small differences were observed in mortality and Medicare program spending across quintiles (one of five groups) of primary care physicians per population. However, beneficiaries residing in areas with the highest quintile of primary care physicians per population had 6 percent lower rates of ACSC hospitalizations, with adjusted rates of 74.90 vs. 79.61 per 1,000 beneficiaries, respectively, for highest vs. lowest quintile of primary care workforce.

Stronger associations were observed in models that used primary care physician FTEs as the measure of primary care workforce. "For example, not only did beneficiaries residing in the highest quintile of primary care FTEs have 5 percent lower mortality, but also 9 percent fewer ACSC hospitalizations and 1 percent higher total Medicare program spending. The adjusted rates of the highest compared with lowest quintile were 5.19 vs. 5.49 deaths per 100 beneficiaries, 72.53 vs. 79.48 ACSC hospitalizations per 1,000 beneficiaries, and $8,857 vs. $8,769 total Medicare spending per beneficiary, respectively. There were significant trends in the association of primary care FTEs with mortality, ACSC hospitalizations, and acute care facility Medicare spending," the authors write.

"Our findings suggest that a higher local workforce of primary care physicians has a generally positive benefit for Medicare populations, but that this association may not simply be the result of having more physicians trained in primary care in an area. Instead, associations were much stronger with a measure of primary care activity that was linked to a central concept of primary care -- ambulatory care delivered in an office or clinic setting by physicians trained in primary care. The FTEs measure also more accurately reflected physician retirement or part-time effort."

"The benefits of primary care workforce appear quite sensitive to the accurate discrimination of those physicians trained in primary care with those practicing ambulatory primary care. Recognizing this difference is important not just to improve primary care clinician measurement, but also as an indication of the drift of physicians trained as primary care physicians to nonprimary care careers. Increasing the training capacity of family medicine and internal medicine may have disappointing patient benefits if the resulting physicians are primary care in name only," the researchers conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. C.-H. Chang, T. A. Stukel, A. B. Flood, D. C. Goodman. Primary Care Physician Workforce and Medicare Beneficiaries' Health Outcomes. JAMA: The Journal of the American Medical Association, 2011; 305 (20): 2096 DOI: 10.1001/jama.2011.665

Cite This Page:

JAMA and Archives Journals. "Higher levels of primary care physicians in area associated with favorable outcomes for patients." ScienceDaily. ScienceDaily, 24 May 2011. <www.sciencedaily.com/releases/2011/05/110524162009.htm>.
JAMA and Archives Journals. (2011, May 24). Higher levels of primary care physicians in area associated with favorable outcomes for patients. ScienceDaily. Retrieved December 21, 2014 from www.sciencedaily.com/releases/2011/05/110524162009.htm
JAMA and Archives Journals. "Higher levels of primary care physicians in area associated with favorable outcomes for patients." ScienceDaily. www.sciencedaily.com/releases/2011/05/110524162009.htm (accessed December 21, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, December 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

The Best Tips to Curb Holiday Carbs

The Best Tips to Curb Holiday Carbs

Buzz60 (Dec. 19, 2014) — It's hard to resist those delicious but fattening carbs we all crave during the winter months, but there are some ways to stay satisfied without consuming the extra calories. Vanessa Freeman (@VanessaFreeTV) has the details. Video provided by Buzz60
Powered by NewsLook.com
Sierra Leone Bikers Spread the Message to Fight Ebola

Sierra Leone Bikers Spread the Message to Fight Ebola

AFP (Dec. 19, 2014) — More than 100 motorcyclists hit the road to spread awareness messages about Ebola. Nearly 7,000 people have now died from the virus, almost all of them in west Africa, according to the World Health Organization. Video provided by AFP
Powered by NewsLook.com
Researchers Test Colombian Village With High Alzheimer's Rates

Researchers Test Colombian Village With High Alzheimer's Rates

AFP (Dec. 19, 2014) — In Yarumal, a village in N. Colombia, Alzheimer's has ravaged a disproportionately large number of families. A genetic "curse" that may pave the way for research on how to treat the disease that claims a new victim every four seconds. Duration: 02:42 Video provided by AFP
Powered by NewsLook.com
The Best Protein-Filled Foods to Energize You for the New Year

The Best Protein-Filled Foods to Energize You for the New Year

Buzz60 (Dec. 19, 2014) — The new year is coming and nothing will energize you more for 2015 than protein-filled foods. Fitness and nutrition expert John Basedow (@JohnBasedow) gives his favorite high protein foods that will help you build muscle, lose fat and have endless energy. Video provided by Buzz60
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins