An Analysis of Mortality, Morbidity, and Primary Care Providers in Arizona's 126 Primary Care Areas

Abstract

The United States is currently facing a primary care provider shortage. Medical schools nationwide have increased enrollment in order offset the effects of the shortage. In order to justify the effects of increasing total quantity of future physicians, there should be a demonstrated relationship between total quantity of providers and a reduction in morbidity / mortality at a population health level. This study investigates if there is any association between the total number of primary care providers and mortality per 100,000 persons (all deaths, heart disease, all cancer, chronic lower respiratory disease, and all accidents), or morbidity per 100,000 persons (chronic diseases, congestive heart failure, hypertension, uncontrolled diabetes, and stroke)? Is there any difference in total number of primary care providers, mortality per 100,000 persons, or morbidity per 100,000 persons in rural vs urban primary care areas? Data was gathered from the Arizona Department of Health Services community profiles dashboard. 2013 morbidity / mortality data for all 126 of Arizona’s Primary Care Areas was analyzed utilizing linear regression and Wilcoxon rank sum. Linear regression demonstrated a statistically significant reduction in a number of mortality / morbidity categories as total number of primary care providers increased. Correlation data demonstrated a statistically significant relationship between number of primary care providers and increase in chronic lower respiratory diseases (p value = 0.027). Additionally, rural primary care areas showed higher incidence of congestive heart failure (p < 0.001) and chronic diseases (p = 0.02) and lower total numbers of primary care providers (p < 0.001) compared with urban primary care areas. Our findings demonstrate distinct differences between urban and rural primary care areas. There may be some association between total number of primary care providers and their potential effect on mortality/morbidity incidence. Further research needs to be completed in order to elucidate a greater understanding of these potential relationships.