Friday, April 24, 2015

The Primary Care Shortage by Region

Areas and population groups that are served by fewer than 1 primary care physician for every 3,500 people earn a shortage area designation from the Health Resources and Services Administration (HRSA).  Approximately 6,100 population groups, encompassing more than 60 million residents,  have been designated as primary care shortage areas by the HRSA.  The HRSA further estimates that nearly 8,100 additional primary care physicians are needed nationally to eliminate these shortage area designations.  To get a perspective on the severity of the primary care shortage by region, we aggregated HRSA State-level data into regions based on classifications used here by the U.S. Bureau of Economic Analysis.

Measuring the severity of the shortage in a given area can take several forms.  A metric that we like is something we call the shortage quotient.   This quotient compares a shortage area's share of the national practitioner deficit against that area's share of the national population that live in shortage areas.  For example, if a specific shortage area had a practitioner shortfall that was 5% of the national shortfall, and that area's population accounted for 4% of the national shortage area population, then its shortage quotient would be 1.25 (5% divided by 4%).  A shortage quotient below 1.0 would mean an area's provider shortage would be less severe than the national average, whereas a shortage quotient above 1.0 would mean the population group had a more severe shortage problem.

As of May, 2014, the biggest deficit was in the Southeast region in absolute terms, where more than 2,360 additional primary care physicians are needed to eliminate shortage conditions.  While that figure represents over 29% of the total primary care physician shortage nationally, the Southeast region holds slightly more than 30% of the population nationally that live in designated shortage areas.  Consequently, the Southeast's shortage quotient is just under 1.0, indicating that it's primary care shortage is on par with the nation as a whole.  The shortage quotient metric reveals that the most severe shortage conditions exist in New England, even thought the region has the smallest primary care physician shortage in absolute terms with a deficit of just 242 providers, or about 3.0% of the national total.  However, that share of the national primary care physician deficit is actually disproportionately large considering that New England only holds about 1.8% of the national population living in designated primary care shortage areas.  These conditions give the New England region a primary care shortage quotient of 1.65 (3% share of national provider deficit divided by 1.8% of the national shortage area population), giving it the worst shortage quotient of any region in the U.S.  

Primary Care Shortage by Region