Health Care Utilization and the Proportion of Primary Care Physicians

Kravet, Steven J.; Shore, Andrew D.; Miller, Redonda G.; Green, Gary B.; Kolodner, Ken; Wright, Scott M.

doi:10.1016/j.amjmed.2007.10.021

Cited by 74 publications

(57 citation statements)

References 23 publications

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“…8, [36][37][38][39] However, high rates of health care cost growth do not appear to be associated with regional primary care physician-to-specialist ratios. 40 Greater numbers of primary care physicians per capita have been associated with lower rates of preventable hospitalization.…”

Section: Primary Care As a Health Systems Orientationmentioning

confidence: 85%

Primary Care: A Critical Review Of The Evidence On Quality And Costs Of Health Care

2010

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Despite contentious debate over the new national health care reform law, there is an emerging consensus that strengthening primary care will improve health outcomes and restrain the growth of health care spending. Policy discussions imply three general definitions of primary care: a specialty of medical providers, a set of functions served by a usual source of care, and an orientation of health systems. We review the empirical evidence linking each definition of primary care to health care quality, outcomes, and costs. The available evidence most directly supports initiatives to increase providers' ability to serve primary care functions and to reorient health systems to emphasize delivery of primary care.

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Section: Primary Care As a Health Systems Orientationmentioning

confidence: 85%

Primary Care: A Critical Review Of The Evidence On Quality And Costs Of Health Care

2010

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“…From a methodological perspective they also differ according to age groups, designs and outcomes. Lower UHA rates were associated with higher general practice supply in two studies7 8 and with higher primary care physician density as an indirect measure of PHC in another 9. However, it is demonstrated that better access to PHC can increase hospital use among some patient populations 10.…”

Section: Introductionmentioning

confidence: 93%

Associations between primary healthcare and unplanned medical admissions in Norway: a multilevel analysis of the entire elderly population

et al. 2014

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ObjectiveTo examine if individual risk of unplanned medical admissions (UMAs) was associated with municipality general practitioner (GP) or long-term care (LTC) volume among the entire Norwegian elderly population.DesignCross-sectional population-based study.Setting428 of 430 Norwegian municipalities in 2009.ParticipantsAll Norwegians aged ≥65 years (n=721 915; 56% women—15% of the total population).Main outcome measureIndividual risk of UMA.ResultsUsing a multilevel analytical framework, consisting of individuals (N=722 464) nested within municipalities (N=428), nested within local hospital areas (N=52) we found no association between municipality GP or LTC volume and UMAs. However, we found that higher LTC levels of provision were associated with fewer hospitalisations among the older age groups. A modest geographical variability was observed for UMA in adjusted analysis.ConclusionsA higher primary healthcare volume was only associated with fewer UMAs among the oldest old in a universally accessible healthcare system.

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“…A study by Kravet et al showed that a high proportion of primary care physicians, compared with other physicians, is associated with lower inpatient and ED visits 5 ; other studies have found that patients who access primary care at community health centers are less likely to have ED visits or hospitalizations for avoidable reasons. 6,7 In recognizing the importance of increasing primary care to reduce ED utilization, the Deficit Reduction Act of 2005 provided up to $4 million funding in grant for states to establish alternate nonemergency provider networks, including increased funding for community health centers.…”

mentioning

confidence: 96%