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Trends in physician availability in 10 urban areas from 1963 to 1980
Summary
Physician availability increased overall in urban areas, but primary care physicians declined significantly in low-income neighborhoods. This highlights persistent inequities in healthcare access despite physician supply growth.
Area of Science:
- Health Services Research
- Urban Health Policy
- Physician Distribution Studies
Background:
- Public policy has focused on overall physician supply, neglecting urban distribution issues.
- Geographic and specialty maldistribution of physicians remains a concern in urban settings.
Purpose of the Study:
- To examine changes in physician availability in urban poverty and nonpoverty areas between 1963 and 1980.
- To assess the impact of overall physician supply growth on urban physician distribution.
Main Methods:
- Analysis of physician availability data in 10 U.S. cities.
- Comparison of changes in poverty versus nonpoverty areas over an 18-year period (1963-1980).
Main Results:
- Overall patient care physician availability increased in both poverty and nonpoverty urban areas.
- Nonpoverty areas experienced greater growth in overall physician availability.
- Office-based primary care physicians declined by 45% in poverty areas and 27% in nonpoverty areas.
Conclusions:
- Increased overall physician supply does not automatically resolve urban geographic and specialty maldistribution.
- Targeted strategies for education, service delivery, and financing are essential to address inequitable physician availability in urban areas.