Table 5.
Adjusted Associations between Change in Primary Care Workforce and 2011 Outcomes by Quintile of 2001 Primary Care Workforce
| Workforce Measure | Quintileb of 2001 Workforce (Median) | Results from Adjusted Models (per Beneficiary)a | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 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 | ||
| An increase of one primary care physicians per 10,000 populationc | Lowest (1.7) | 0.998 | (0.991–1.005) | .570 | 0.998 | (0.992–1.003) | .391 | 1.001 | (0.999–1.003) | .481 |
| 2 (3.5) | 0.997 | (0.989–1.005) | .501 | 0.997 | (0.991–1.004) | .457 | 0.999 | (0.996–1.001) | .285 | |
| 3 (4.4) | 0.990 | (0.983–0.998) | <.05 | 0.995 | (0.989–1.001) | .114 | 1.001 | (0.999–1.003) | .434 | |
| 4 (5.3) | 0.998 | (0.991–1.005) | .624 | 0.996 | (0.990–1.002) | .191 | 0.998 | (0.996–1.001) | .216 | |
| Highest (7.5) | 1.000 | (0.995–1.004) | .873 | 0.993 | (0.989–0.996) | <.05 | 1.004 | (1.003–1.006) | <.05 | |
| An increase of one medicare primary care full‐time equivalents per 10,000 beneficiariesd | Lowest (5.1) | 0.988 | (0.980–0.997) | <.05 | 0.997 | (0.990–1.004) | .374 | 0.990 | (0.988–0.993) | <.05 |
| 2 (6.0) | 0.986 | (0.977–0.995) | <.05 | 0.973 | (0.965–0.980) | <.05 | 0.976 | (0.973–0.979) | <.05 | |
| 3 (6.5) | 0.984 | (0.975–0.993) | <.05 | 0.982 | (0.974–0.989) | <.05 | 0.982 | (0.979–0.985) | <.05 | |
| 4 (7.1) | 0.978 | (0.970–0.985) | <.05 | 0.973 | (0.967–0.979) | <.05 | 0.975 | (0.972–0.977) | <.05 | |
| Highest (8.1) | 0.988 | (0.982–0.995) | <.05 | 0.981 | (0.975–0.986) | <.05 | 0.983 | (0.981–0.985) | <.05 | |
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.
Adjusted for 2011 individual patient characteristics (age, sex, race, chronic conditions), 2001 area patient characteristics, difference in area patient characteristics, 2001 area outcome, 2001 workforce, and area urban indicator, area median household income, area specialty supply, and area hospital bed supply (hospitalizations and emergency department visits).
Equal‐population size.
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.