Quantifying the health benefits of primary care physician supply in the United States.
This analysis addresses the question, Would increasing the number of primary care physicians improve health outcomes in the United States? A search of the PubMed database for articles containing "primary care physician supply" or "primary care supply" in the title, published between 1985 and 2005, identified 17 studies, and 10 met all inclusion criteria. Results were reanalyzed to assess primary care effect size and the predicted effect on health outcomes of a one-unit increase in primary care physicians per 10,000 population. Primary care physician supply was associated with improved health outcomes, including all-cause, cancer, heart disease, stroke, and infant mortality; low birth weight; life expectancy; and self-rated health. This relationship held regardless of the year (1980-1995) or level of analysis (state, county, metropolitan statistical area (MSA), and non-MSA levels). Pooled results for all-cause mortality suggest that an increase of one primary care physician per 10,000 population was associated with an average mortality reduction of 5.3 percent, or 49 per 100,000 per year.
Macinko
James
J
RWJ Health and Society Scholars Program, University of Pennsylavnia, Philadelphia 19104-6218, USA. macinko@wharton.upenn.edu
Starfield
Barbara
B
Shi
Leiyu
L
D006305:Health Status Indicators; D006801:Humans; D009026:Mortality; D010821:Physicians, Family / Q000600:supply & distribution*; D011320:Primary Health Care; D014481:United States / Q000453:epidemiology; D000078329:Workforce