Regional and Racial Variation in Primary Care and the Quality of Care Among Medicare Beneficiaries

Meeting the nation’s primary care needs is more than a numbers game. A new report from the Dartmouth Atlas Project shows that neither higher amounts of primary care services, nor making sure patients routinely see a primary care clinician is, by itself, a guarantee that a patient will get recommended care or experience better outcomes.

The report, which studies the fee-for-service Medicare population from 2003 to 2007, shows that improving access to primary care alone does not always keep people with chronic conditions out of the hospital, improve their chances of getting the optimal care recommended for their condition, or improve health outcomes. Researchers also found that patients’ access to and use of primary care, the quality of overall care, and their likelihood of hospitalization varied markedly in different locations.

Despite the central role that primary care can play, access is not always enough to ensure that patients receive high-quality care. Achieving the benefits of primary care is likely to require both improving the services provided by primary care clinicians and more effective integration and coordination with other providers.