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Obstetrical practice among new rural family physicians
1Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, USA.
The Journal of Family Practice
|May 1, 1995
Summary
Rural family physicians are more likely to provide maternity care when they own their practice and are not solo practitioners. Community factors, not malpractice costs or Medicaid rates, predict maternity care provision.
Area of Science:
- Medical Practice Management
- Rural Health
- Obstetrics
Background:
- Declining numbers of family physicians in maternity care exacerbate rural obstetrical care access issues.
- This study investigates factors influencing maternity care provision by new rural family physicians.
Purpose of the Study:
- To identify key factors affecting the likelihood of rural family physicians providing maternity care.
- To understand practice and community influences on rural obstetrical care provision.
Main Methods:
- Surveyed 782 family physicians who relocated to nonmetropolitan areas (1987-1990).
- Oversampled physicians in health professional shortage areas.
- Analyzed data from 338 eligible respondents with a 72% response rate.
Main Results:
- 45% of rural family physicians provided routine deliveries.
- Physicians owning their practice and not being solo practitioners were more likely to offer maternity care (P <= .05).
- Maternity care provision correlated with less populated counties, fewer obstetricians, and more family physicians.
Conclusions:
- Practice and community characteristics are primary predictors of rural family physicians providing maternity care.
- Contrary to common belief, malpractice insurance costs and Medicaid reimbursement rates did not influence the likelihood of providing maternity care.