The National Health Service Corps and Medicaid inpatient care: experience in a southern state.
BACKGROUND
Since 1970, the National Health Service Corps (NHSC) has worked to increase primary care access among underserved groups. This study examined whether NHSC alumni physicians were likely to treat a high proportion of Medicaid patients in their practices.


METHODS
Using licensure files and hospital discharge data, we identified all physicians practicing in South Carolina who attended at least one discharge in 1998, excluding physicians who graduated before 1969, residents, and current NHSC-obligated physicians. The outcome studied was ranking in the highest quartile for Medicaid participation.


RESULTS
Former NHSC participants, after adjustment for personal characteristics, education, and specialty, were nearly twice as likely to fall into the category of high Medicaid participation. NHSC physicians were more likely to practice in community health centers and to locate in areas with a health professions shortage and counties with high percentages of minorities and people living in poverty.


CONCLUSIONS
NHSC alumni make career choices leading them to serve low-income patients.
D001741:Black or African American / Q000706:statistics & numerical data; D002321:Career Choice; D003151:Community Health Centers / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008007:Licensure, Medical / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008507:Medically Underserved Area; D008913:Minority Groups / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D010351:Patient Discharge; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011365:Professional Practice Location / Q000706:statistics & numerical data; D013022:South Carolina; D014146:Training Support / Q000706:statistics & numerical data; D035862:Vulnerable Populations / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data