Dartmouth study says primary care not always a cure-all

Sep 10 2010

A new study by Dartmouth Health Atlas researchers contends that making primary care more widely accessible -- one of the goals of the health overhaul -- won't necessarily improve the nation's health, Reuters reports. The researchers found wide variations in the quality of care that do not always match up with the level of access to physicians. One Dartmouth researcher said, "Our findings suggest that the nation's primary care deficit won't be solved by simply increasing access to primary care, either by boosting the number of primary care physicians in an area or by ensuring that most patients have better insurance coverage." Those are two central tenets of the health overhaul (Fox, 9/9).

Wall Street Journal's Health Blog: Despite a dearth of primary care doctors in Wilmington, N.C., and a relative plethora in White Plains, N.Y., "87.4% of Wilmington Medicare recipients had at least one annual primary-care visit during 2003-07, compared to fewer than 70% of White Plains' beneficiaries," the report found. "Those stats underlie one of the report's major conclusions: 'There is no simple relationship between the supply of physicians and access to primary care.'" Furthermore, the researchers said just seeing the doctor isn't necessarily helpful: In some cases, those who saw doctors still didn't receive recommended care (Hobson, 9/9).

Medical News Today: Also, "[r]acial disparities in quality and outcomes might not be overcome just by increasing access to primary care, the authors found. Although African-Americans had half the chance of seeing a primary care clinician and had an 84% higher risk of being hospitalized than Caucasians within areas, these disparities were less pronounced than differences across locations" (Nordqvist, 9/10).

Kaiser Health News: "The researchers did identify some benefits that came from annual doctor's visits. Female Medicare beneficiaries between ages 67 and 69 who saw a primary care physician annually were more likely to get a mammogram once every two years. Diabetics were more likely to get A1c hemoglobin blood tests to measure how their blood sugar was controlled. But they were no more likely to get blood lipid testing or eye examinations, two other tests that are recommended by the American Diabetes Association" (Rau, 9/9).

NPR's blog Shots/Kaiser Health News tally some of the interesting findings: McAllen, Texas, was the leg amputation capital of the nation with 3.29 per 1,000 Medicare enrollees. Provo, Utah, had the lowest rate, at only 0.33 per 1000 enrollees. People who live in Florence, S.C., were most likely to see a primary care doctor. Eighty-eight percent saw one at least once a year. The Bronx had the worst showing in that category -- only 60.2 percent made it to the doctor each year (Rau, 9/9).