Back to Search
Start Over
Primary Care Attributes and Mortality: A National Person-Level Study
- Source :
- The Annals of Family Medicine. 10:34-41
- Publication Year :
- 2012
- Publisher :
- Annals of Family Medicine, 2012.
-
Abstract
- PURPOSE Research demonstrates an association between the geographic concentration of primary care clinicians and mortality in the area, but there is limited evidence of a mortality benefit of primary care at the individual patient level. We examined whether patient-reported access to selected primary care attributes, including some emphasized in the medical home literature, is associated with lower individual mortality risk. METHODS We analyzed data from 2000–2005 Medical Expenditure Panel Survey respondents aged 18 to 90 years (N = 52,241), linked to the National Death Index through 2006. A score was constructed from 5 yes/no items assessing whether the respondent’s usual source of care had 3 attributes: comprehensiveness, patient-centeredness, and enhanced access. Scores ranged from 0 to 1 (higher scores = more attributes). We examined the association between the primary care attributes score and mortality during up to 6 years of follow-up using Cox survival analysis, adjusted for social, demographic, and health-related characteristics. RESULTS Racial/ethnic minorities, poorer and less educated persons, individuals without private insurance, healthier persons, and residents of regions other than the Northeast reported less access to primary care attributes than others. The primary care attributes score was inversely associated with mortality (adjusted hazard ratio = 0.79; 95% confidence interval, 0.64–0.98; P = .03); supplementary analyses showed mortality decreased linearly with increasing score. CONCLUSIONS Greater reported patient access to selected primary care attributes was associated with lower mortality. The findings support the current interest in ensuring that patients have access to a medical home encompassing these attributes.
- Subjects :
- Adult
Male
Medical home
medicine.medical_specialty
Adolescent
Ethnic group
National Death Index
Health Services Accessibility
Young Adult
Surveys and Questionnaires
Ethnicity
Humans
Medicine
Healthcare Disparities
Mortality
Young adult
Original Research
Aged
Aged, 80 and over
Primary Health Care
business.industry
Hazard ratio
Health Status Disparities
Middle Aged
Health Surveys
United States
Confidence interval
Socioeconomic Factors
Family medicine
Respondent
Regression Analysis
Female
Medical Record Linkage
Family Practice
business
Medical Expenditure Panel Survey
Demography
Subjects
Details
- ISSN :
- 15441717 and 15441709
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- The Annals of Family Medicine
- Accession number :
- edsair.doi.dedup.....f74a431a1804b95f9a21ef7197013dd9