Access to quality primary care reduces mortality

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Access to Quality Primary Care Reduces Mortality Risk
Access to Quality Primary Care Reduces Mortality Risk

HealthDay News -- Greater access to high-quality primary medical care is associated with a reduced risk of death and supports the benefits of adopting aspects of the medical home model, study data published in the January/February issue of the Annals of Family Medicine indicate.

Anthony Jerant, MD, of the University of California Davis School of Medicine in Sacramento, Calif., and colleagues analyzed data from 52,241 people aged 18 to 90 years that participated in the 2000 to 2005 Medical Expenditure Panel Survey.

The survey contained five yes/no items that the researchers used to evaluate primary-care quality based on three attributes: comprehensiveness, patient-centeredness and the availability of extended office hours. Scores ranged from zero to one, with higher scores indicating the presence of more attributes and higher quality care. The researchers then evaluated the association between scores and mortality during a six-year follow-up period.

An inverse association was observed between primary care attribute scores and mortality (adjusted HR=0.79; 95% CI: 0.64–0.98; P=0.03), with mortality decreasing linearly as scores increased.

Several social- and demographic-based disparities in access to quality primary care may exist, the researchers noted. They found that racial and ethnic minorities, people of lower socioeconomic means, those without private insurance, healthier people and those residing in regions outside the Northeast reported lower primary care scores.

"The findings support the current interest in ensuring that patients have access to a medical home encompassing these attributes," the researchers wrote, adding that "ongoing health care and primary care practice redesign efforts in the United States may have the potential to reduce preventable deaths."

Study limitations included self-reported patient data, the observational nature of the analysis and a lack of information regarding the relative importance of a given primary care attribute on mortality reduction.

Jerant A, Fenton JJ, Franks P. Ann Fam Med. 2012;10;34-41.

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