Projecting the need for physicians to care for older persons: effects of changes in demography, utilization patterns,...

To determine the influence of differing assumptions of population growth, visit rates, prevalence of functional impairment, physician productivity, and hospitalization rates on projected need for physicians to provide medical care for older persons.

Sensitivity analysis of a manpower model.

The factors that appear to have the most impact on projections of physician need are related to physician productivity, especially delegation to mid-level providers, and case-mix. Other factors, such as the variability of census projections and per capita visit rates, are likely to have less effect on overall physician supply needs.

Although case mix and delegation to mid-level providers may both substantially affect the need for physician supply to care for older persons, only the latter can be directly affected by health policy decisions. Consideration should be given to increasing the supply of mid-level providers and providing incentives for patients and physicians to receive and provide care in delivery systems that utilize mid-level providers extensively.