Association between Temporal Changes in Primary CareWorkforce and Patient Outcomes
Association between Temporal Changes in Primary CareWorkforce and Patient Outcomes
复制标题
DOI：
10.1111/1475-6773.12513
复制
发表时间：
2017-04-01
影响因子：
3.4
通讯作者：
Goodman, David C.
中科院分区：
文献类型：
--
作者：
Chang, Chiang-Hua;O'Malley, A. James;Goodman, David C.
Objectives examined the association between 10-year temporal changes in the primary care workforce and Medicare beneficiaries'outcome.Data Sources2001 and 2011 American Medical Association Masterfiles and fee-for-service Medicare claims.Study Design/MethodsWe calculated two primary care workforce measures within the Primary Care Service Areas：每10，000人口（人均）的初级保健医生数量和每10，000名Medicare受益人的Medicare初级保健全职等效人员（FTE）数量。三个结局为死亡率、门诊护理敏感性疾病（ACSC）住院和急诊科（艾德）访视。我们使用泊松回归模型测量了初级保健工作人员的变化与患者结局之间的边际相关性。主要发现每10，000人中增加一名初级保健医生与每100，000人中死亡人数减少15.1人和ACSC住院人数减少39.7人相关（均为p
ObjectiveTo examine the association between 10-year temporal changes in the primary care workforce and Medicare beneficiaries' outcomes.Data Sources2001 and 2011 American Medical Association Masterfiles and fee-for-service Medicare claims.Study Design/MethodsWe calculated two primary care workforce measures within Primary Care Service Areas: the number of primary care physicians per 10,000 population (per capita) and the number of Medicare primary care full-time equivalents (FTEs) per 10,000 Medicare beneficiaries. The three outcomes were mortality, ambulatory care-sensitive condition (ACSC) hospitalizations, and emergency department (ED) visits. We measured the marginal association between changes in primary care workforce and patient outcomes using Poisson regression models.Principal FindingsAn increase of one primary care physician per 10,000 population was associated with 15.1 fewer deaths per 100,000 and 39.7 fewer ACSC hospitalizations per 100,000 (both p