Association of number of primary care physicians with preventable hospitalizations and premature deaths

ABSTRACT

Background

Primary care physicians (PCPs) may be the first providers for patients in a healthcare interaction, putting them in a unique position that may determine the health trajectory of a patient. Assessing whether PCPs improve the overall health of a community through reducing preventable hospital stays and premature deaths may provide necessary information towards improving the health outcomes at grassroots.

Methods

County-level data on the number of primary care physicians, preventable hospital stays and ‘years of potential life lost’ (YPLL) were obtained from the Physician Master File data of the American Medical Association, Centers for Medicare & Medicaid Services Office of Minority Health’s Mapping Medicare Disparities data, and Center for Disease Control and Prevention’s WONDER database, respectively. We employed linear regression model to assess the association of PCP rate with preventable hospital stays and YPLL.

Results

Preventable hospitalization rate in the United States was 6303.4 (95% CI, 6212.5–6394.3) hospitalizations per 100,00 population, while the average YPLL across the counties in the United States was 7792.9 (95% CI, 7697.6–7888.3) years per 100,000 population. For an increase of 1 PCP in a county, around 16 hospitalizations were prevented per 100,000 population (P = 0.001) each year. Furthermore, around 14 years of life were saved per 100,000 population for every additional PCP in a county across the United States (P < 0.001).

Conclusion

Higher number of PCPs in a county was associated with lower hospitalizations for preventable causes and lower premature deaths. Increasing PCPs may be an important metric to improve overall health in a community.

KEYWORDS:

• Premature mortality
• years of potential life lost
• preventable hospitalization
• primary care practitioner

Disclosure of financial/other conflicts of interest

The authors have no relevant conflicts of interest to disclose. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

None stated.

Additional information

Funding

No funding was obtained for this study.