Table 3.
Unadjusted Associations between Change in Primary Care Workforce and 2011 Outcomes
| Results from Unadjusted Models (per Beneficiary) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Mortality | Hospitalizations for Ambulatory Care–Sensitive Conditions | Total Emergency Department Visits | |||||||
| Risk Ratio | 95% CI | p‐value | Risk Ratio | 95% CI | p‐value | Risk Ratio | 95% CI | p‐value | |
| Workforce measure | |||||||||
| An increase of one primary care physicians per 10,000 populationa | 1.001 | (0.999–1.004) | .329 | 0.987 | (0.985–0.990) | <0.05 | 1.002 | (1.001–1.003) | <.05 |
| Based on 2001 U.S. average by increase 1 per 10,000 workforce | Associated increase of 7.2 per 100,000 | Associated reduction of 105.6 per 100,000 | Associated increase of 72.0 per 100,000 | ||||||
| An increase of one Medicare primary care full‐time equivalents per 10,000 beneficiariesb | 0.997 | (0.993–1.000) | .058 | 1.021 | (1.018–1.024) | <0.05 | 1.005 | (1.003–1.006) | <.05 |
| Based on 2001 U.S. average by increase 1 per 10,000 workforce | Associated reduction of 18.0 per 100,000 | Associated increase of 176.9 per 100,000 | Associated increase of 179.4 per 100,000 | ||||||
To calculate associated change, for example, we applied the annual morality for 2001 of 5,610 per 100,000 from Table 1 to compute the reduction in the number of deaths per 100,000 as: 5,610*(1 − 1.001291) = −7.24 for per capita measure; 5,610*(1 − 0.996797) = 17.97 for full‐time equivalents measure.
The risk ratios show the direction of change.
If the value of risk ratio is >1, then adding workforce is associated with an increased outcome.
If the value of risk ratio is <1, then adding workforce is associated with a decreased outcome.
Age–sex‐adjusted office‐based American Medical Association Masterfile clinically active primary care physicians per 10,000 total population.
Age–sex–race‐adjusted office‐based primary care full‐time equivalents per 10,000 study beneficiaries.