tailieunhanh - Spatial analysis of elderly access to primary care services

A growing body of literature argues that the availability and mix of physician specialties in areas is important for health outcomes. Areas with fewer specialists but higher generalists per capita were found to have better health outcomes or quality of care [21,22]. Goodman [23] found that greater physician supply is associated with both higher area income and lower mortality rates, and argued that regional variations in health outcomes and physician supply will exist as long as there are differences across communities in economic status. A long-standing tenet of state and federal physician workforce policy is that the provision of income supplements to physicians in rural areas will help attract physicians to these areas | BioMed Central International Journal of Health Geographies Research Open Access Spatial analysis of elderly access to primary care services Lee R Mobley 1 Elisabeth Root1 Luc Anselin2 Nancy Lozano-Gracia2 and Julia Koschinsky2 Address 1RTI International 275 Cox 3040 Cornwallis Road Research Triangle Park NC 27709-2194 USA and 2University of Illinois Urbana- Champaign 220 Davenport Hall 607 South Mathews Avenue Urbana IL 61801-3671 USA Email Lee R Mobley - lmobley@ Elisabeth Root - eroot@ Luc Anselin - anselin@ Nancy Lozano- Gracia - lozano@ Julia Koschinsky - koschins@ Corresponding author Published 15 May 2006 Received 02 April 2006 International Journal of Health Geographies 2006 5 19 doi 1476-072X-5-19 Accepted 15 May 2006 This article is available from http content 5 1 19 2006 Mobley et al licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Background Admissions for Ambulatory Care Sensitive Conditions ACSCs are considered preventable admissions because they are unlikely to occur when good preventive health care is received. Thus high rates of admissions for ACSCs among the elderly persons aged 65 or above who qualify for Medicare health insurance are signals of poor preventive care utilization. The relevant geographic market to use in studying these admission rates is the primary care physician market. Our conceptual model assumes that local market conditions serving as interventions along the pathways to preventive care services utilization can impact ACSC admission rates. Results We examine the relationships between market-level supply and demand factors on market-level rates of ACSC admissions among the elderly residing in the . in .