Primary Care Physician Workforce and Medicare Beneficiaries' Health Outcomes

A study measuring the relationship between the adult primary care physician workforce and patient outcomes found that a more concentrated physician workforce was usually associated with better patient outcomes.

The authors of this study analyzed annual individual patient outcomes, including mortality, ambulatory care sensitive condition hospitalization and Medicare spending, by physician workforce. They examined a sample of Medicare beneficiaries age 65 or older per Medicare beneficiary, using the number of physicians in the American Medical Association (AMA) Masterfile and at primary care clinical full-time equivalents (FTEs). The authors used geographic service areas reflecting how primary care services are used as a measure of physician workforce and sorted the areas into quintiles based on physician workforce level.

Patients residing in areas with the highest quintile of AMA physicians had fewer hospitalizations, lower mortality and a similar amount of Medicare spending as those in the lowest quintile. Patients residing in areas with the highest quintile of FTEs also had fewer hospitalizations and lower mortality and higher Medicare spending as compared to the lowest quintile, and the association between physician workforce and patient outcomes was stronger for FTEs.

The authors argue that the stronger association between FTE workforce and patient outcomes suggests that improved outcomes are associated with the amount of available ambulatory care rather than the number of available primary care physicians.