Designating places and populations as medically underserved: a proposal for a new approach

Area of Science:

• Health Services Research
• Healthcare Access Metrics
• Primary Care Distribution Analysis

Background:

• Current Health Professional Shortage Area (HPSA) and Medically Underserved Area (MUA) designations lack a data-driven, theory-based foundation.
• Existing designation systems may not accurately reflect current primary care access challenges.

Purpose of the Study:

• To develop and evaluate a novel, data-driven metric for designating areas with primary care access needs.
• To create a replacement system for HPSA and MUA designations that is theory-based and scalable.

Main Methods:

• Utilized primary medical care utilization and practitioner distribution data.
• Developed a scoring system estimating community-level effective primary care access.
• Incorporated stakeholder input throughout the development process.

Main Results:

• The proposed formula designates over 90% of current geographic and low-income population HPSA designations.
• The method demonstrates scalability, allowing adjustments for local variations in need.
• Stakeholder groups found the approach acceptable.

Conclusions:

• A data-driven, theory-based metric can effectively calculate relative need for primary care in geographic areas and special populations.
• Successful implementation requires careful explanation and support for affected groups.