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Preventive Healthcare Services01:30

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Primary Healthcare Services01:30

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Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
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Primary care appointment availability and preventive care utilization: evidence from an audit study.

Brendan Saloner1, Daniel Polsky2, Ari Friedman2

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Insurance expansions may affect primary care access. Higher private insurance appointment availability correlated with lower preventive care use, while Medicaid access showed no significant impact on utilization.

Keywords:
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Area of Science:

  • Health Services Research
  • Public Health Policy
  • Preventive Medicine

Background:

  • Affordable Care Act (ACA) insurance expansions increased demand for primary care.
  • Concerns exist regarding primary care access in areas with newly insured populations.
  • Preventive care utilization is a key indicator of primary care access.

Purpose of the Study:

  • To examine the relationship between primary care appointment availability and preventive care utilization.
  • To investigate differences in this relationship based on insurance status (private vs. Medicaid).
  • To assess the impact of insurance expansions on healthcare access in local communities.

Main Methods:

  • Linked individual-level preventive care data (Behavioral Risk Factor Surveillance System) with county-level primary care appointment availability data (experimental audit study).
  • Utilized multivariate regression analyses controlling for county-level socioeconomic factors (uninsurance, poverty, unemployment).
  • Analyzed data from 10 states between 2011-2013.

Main Results:

  • Higher availability of primary care appointments for privately insured adults was associated with significantly lower preventive care utilization among this group.
  • This association was attenuated after controlling for socioeconomic factors.
  • Increased availability of Medicaid appointments was linked to higher, though not statistically significant, preventive care use for Medicaid enrollees.

Conclusions:

  • The relationship between primary care access and preventive care utilization varies significantly by insurance type.
  • Primary care appointment availability alone may not fully explain preventive care utilization patterns.
  • Healthcare policy must consider insurance status when addressing primary care access and utilization.