Physician supply, physician diversity, and outcomes of primary health care for older persons in the United States.
This study examines effects of physician supply and diversity on hospitalization for ambulatory care sensitive conditions (ACSH). Data are from 31 metropolitan areas in the 1984-1990 United States Longitudinal Study of Aging, and the Area Resource File. Discrete-time hazard models estimate ACSH risk. High ACSH risk may indicate problems with the accessibility or quality of primary care. Results show low supply areas have high risk. Adequate supply areas have significantly lower risk. Areas with greater supply have high risk, which may indicate supplier-induced hospitalization. Greater physician diversity reduces ACSH risk. Results support policies promoting physician placement in underserved areas, and those that educate minority physicians.
Laditka
James N
JN
Arnold School of Public Health, University of South Carolina, Columbia 29208, USA. jladitka@gwm.sc.edu
D000368:Aged; D000553:Ambulatory Care; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006299:Health Services for the Aged / Q000600:supply & distribution*; D006801:Humans; D008297:Male; D008511:Medicine; D008913:Minority Groups; D017063:Outcome Assessment, Health Care; D010820:Physicians / Q000600:supply & distribution*; D011320:Primary Health Care; D013038:Specialization; D014481:United States; D014505:Urban Population