Source: American Board of Family Medicine
A recent study found that every 10 additional primary care physicians per 100,000 people in the United States was associated with a 51.5-day increase in life expectancy across counties. Within natural primary care markets (Primary Care Service Areas) this increased to 117.3 days. During the period studied, 2005–15; however, the number of primary care physicians decreased over 5%, from 46.6 to 41.4 per 100,000 people, with greater losses in rural areas.
The researchers found significant relationships for reduction in cardiovascular mortality (0.9%), cancer mortality (1%), and respiratory mortality (1.4%) with an increased number of primary care physicians. There was no relationship to mortality due to conditions which medical care should not affect such as infectious diseases, substance abuse, or injury. The association between primary care physician density and life expectancy was not as strong as that of poverty (one-fifth as potent) and tobacco (two-thirds as potent).
“Many believe that a well-functioning health care system requires a solid foundation of primary care. However, persistent payment disparities between primary care and procedural specialties continue to erode the US primary care physician workforce,” the study said. Policy initiatives increasingly focus on population health and spending, but the programs fail to specifically direct more resources to primary care.
“This research, using sophisticated methods to explore the relationship between primary care and mortality, reinforces studies by Barbara Starfield and Leiyu Shi more than a decade ago,” said Robert Phillips, MD, MSPH, executive director for the American Board of Family Medicine Foundation’s Center for Professionalism and Value in Healthcare. “In an era of value-based payments and population health, these findings will hopefully help insurance companies and health systems reevaluate their support for comprehensive primary care. The erosion of primary care physician workforce in rural areas is very concerning and should turn a spotlight on the policies and training models that are failing rural areas.”
The researchers’ findings were published February 18 in the JAMA Internal Medicine.
The study was conducted by researchers at Stanford Medical School, Harvard Medical School, the University of North Carolina-Chapel Hill, and the American Board of Family Medicine.