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Physician Multisite Practicing: Impact on Access to Care
1From Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, TX; Department of Family Medicine, Georgetown University Medical Center, Washington, DC; and Department of Geography and Anthropology, Louisiana State University, Baton Rouge. imam.xierali@utsouthwestern.edu.
Background:
Physician multisite practicing may affect access to care. However, study measuring the degree of multisite practicing is generally lacking. This study aimed to describe physician multisite practicing patterns in Georgia and to assess its impact on access to care.
Methods:
Using data from the Georgia Medicaid Management Information System, the American Medical Association Physician Masterfile, and the US Census, mean number of practice sites per physician was calculated. Counts of sites per physician were then modeled in a negative binomial regression. Local differences in spatial accessibility were assessed based on single-site verse multisite practice locations.
Results:
Among 20,116 physicians (mean age, 49.4 years; 30.5% female) in Georgia, 63.2% reported multiple practice sites. The average practice sites per physician was 3.3 overall, 2.6 for primary care physicians, and 3.6 for other physicians. Younger age, male sex, and practicing in group practice setting were associated with a higher number of practice sites per physician. Spatial accessibility index changed substantially when controlling for multiple practice sites.
Conclusions:
Physician multisite practicing was prevalent and affected geographic access to care. More research and investment into health workforce information infrastructure seem warranted to accommodate changing physician practice patterns in data collection and dissemination.
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