Ying Xue1, Elizabeth Greener2, Viji Kannan2, Joyce A Smith3, Carol Brewer4, Joanne Spetz5. 1. University of Rochester School of Nursing, Rochester, NY. Electronic address: ying_xue@urmc.rochester.edu. 2. Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY. 3. Clinical Nursing, University of Rochester School of Nursing, Rochester, NY. 4. School of Nursing, University at Buffalo, Buffalo, NY. 5. Philip R. Lee Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, San Francisco, CA; Healthforce Center, University of California, San Francisco, San Francisco, CA.
Abstract
BACKGROUND: Federally qualified health centers (FQHCs) were designed to provide care in medically underserved areas. Substantial and sustained federal funding has accelerated FQHC growth. PURPOSE: To examine temporal trends in primary care provider supply and whether FQHCs have been successful in reducing the gap in provider supply in primary care health professional shortage areas (HPSAs). METHODS: Retrospective cohort study design using national county-level data from 2009 to 2013. Primary care providers included physicians, nurse practitioners, and physician assistants. FINDINGS: Partial-county HPSAs had the highest average provider supply and the greatest increase, followed by non-HPSA counties and whole-county HPSAs. The provider gap was larger in whole-county HPSAs compared with partial-county HPSAs. Counties with one or more FQHC sites had a smaller provider gap than those without FQHC sites. An increase of one FQHC site was statistically significantly associated with a reduction in the annual provider gap. DISCUSSION: FQHCs reduced the gap in primary care provider supply in shortage counties and mitigated uneven distribution of the primary care workforce.
BACKGROUND: Federally qualified health centers (FQHCs) were designed to provide care in medically underserved areas. Substantial and sustained federal funding has accelerated FQHC growth. PURPOSE: To examine temporal trends in primary care provider supply and whether FQHCs have been successful in reducing the gap in provider supply in primary care health professional shortage areas (HPSAs). METHODS: Retrospective cohort study design using national county-level data from 2009 to 2013. Primary care providers included physicians, nurse practitioners, and physician assistants. FINDINGS: Partial-county HPSAs had the highest average provider supply and the greatest increase, followed by non-HPSA counties and whole-county HPSAs. The provider gap was larger in whole-county HPSAs compared with partial-county HPSAs. Counties with one or more FQHC sites had a smaller provider gap than those without FQHC sites. An increase of one FQHC site was statistically significantly associated with a reduction in the annual provider gap. DISCUSSION: FQHCs reduced the gap in primary care provider supply in shortage counties and mitigated uneven distribution of the primary care workforce.
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