Health care Utilization and Expenditures in Health Professional Shortage Areas

Area of Science:

• Health Services Research
• Healthcare Policy
• Public Health

Background:

• Healthcare provider shortages are linked to negative health outcomes due to limited primary care access.
• Health Professional Shortage Areas (HPSAs) are designated regions facing provider scarcity.

Purpose of the Study:

• To investigate the impact of HPSAs on healthcare utilization and spending.
• To identify disparities in these impacts across different demographics and care types.

Main Methods:

• Utilized Medical Expenditure Panel Survey data from 2002-2019.
• Employed a generalized random forest model to analyze healthcare utilization differences between HPSAs and non-HPSAs.
• Examined heterogeneous treatment effects to understand varied impacts.

Main Results:

• HPSAs were associated with a 5% decrease in medical office visits.
• No significant reduction in hospital-based care utilization was observed.
• Impacts were concentrated among older adults, Black individuals, and Medicaid beneficiaries in urban settings.
• No statistically significant changes in annual healthcare spending were found.

Conclusions:

• HPSAs disproportionately affect access to outpatient care for vulnerable populations.
• Targeted interventions are needed to address provider shortages and improve healthcare access in underserved areas.
• Findings suggest focusing policy efforts on primary care access within HPSAs.