More Docs to primary care in a community equals healthier seniors

primary care physicians more a community, especially those that are actually practicing primary care, that community healthier seniors are, suggests a new study by Dartmouth.

These communities see less avoidable hospitalizations and a slightly lower rate of mortality among seniors, the researchers found.

"This reinforces something resisted the American family physicians [AAFP] Academy for a long time: that a competent doctor can maintain results," said AAFP President Dr. Roland Goertz, who had observed that some 100 different studies is today the identical or similar conclusions. "."

This study and others come in the context of a pool of shrinkage of primary care physicians. A study last month revealed that the percentage of medical students who want to go into medicine for primary health care has fallen sharply during the past two decades, from 57% in 1990 to 33 for one hundred and twenty years later.

In 1990, 57 per cent wanted to go into medicine primary care against 33 per cent in 2007, this previous study. Those who choose to practice general internal medicine in 2007 fell by 9% to 2%. And in 2008, the medical students only 264 U.S. chose residency training in internal medicine, primary health care, compared to 575 in 1999.

But having more physicians primary care is a cornerstone of most of the strategies to improve the quality of health care and reduce costs to the United States, the authors of the current study report. Their finding appears in the issue of the Journal of the American Medical Association on May 25.

These authors have watched doctor claims for Medicare recipients about 5 million of 65 years and older from files of the American Medical Association. Claims coding for medical specialty and the type of care provided, said the author of the study Chiang-Hua Chang, an instructor of research with the Center for Health Policy Research at the Dartmouth Institute for health and clinical practice in the LibanN.H policy.

Elderly people in the regions where the greatest number of primary care physicians were less avoidable hospitalizations and fewer deaths.

The differences were certainly small. For example, the recruits of Medicare living in areas where the most per capita primary care physicians had a lower rate of 6% of preventable hospitalizations.

But the authors also found that it is not enough just to receive training in primary health care. To be practical primary care as well, something that future studies should take into account, the doctors said Chang.

Many trained primary care physicians appear to be exercising in specialties like emergency medicine, or only inpatient care, she added.

"I think that this raises several important issues," said Dr. Lawrence c. Kleinman, Associate Professor of evidence and health policy at the Mount Sinai School of Medicine in New York. "We must ensure that there is adequate distribution of these physicians and primary care physicians."

"Right now, we tend to be paid when physicians of things, but we tend to value when doctors prevent things, which means manpower moves from primary health care for specialized care,", he added.

The shortage will leave?

"Not in the way in which we currently organize and fund care", said Kleinman. "Medical students react to their value and their market forces and currently the amount of the debt and the repayment of variances are trumping the values of the people and other preferences."