Eliminating Primary Care Health Professional Shortage Areas

Objective: This study examines the geographic distribution of primary care physician workforce in Health Professional Shortage Areas (HPSAs). A HPSA is a geographically defined area designated as having inadequate access to health care. There are 2783 primary care HPSAs with a total of 99.4 million residents across the U.S. in 2007.

Methods: Physicians practice locations are geocoded from the 2007 American Medical Association (AMA) Master File. Their locations are then overlaid on primary care HPSA areas (obtained from HRSA Data Warehouse, March 14, 2008). We use the common indicator of population to physician ratios at 3000:1, 2000:1, and 1500:1 to assess the status of physician shortages.

Results: The results show a range of severity of primary care workforce shortages across the U.S.: within current HPSAs, 933 HPSA with 17.2 million residents have ratios at or above 3000:1 and would require a shift of only 2158 extra primary care physicians to eliminate shortage areas; 1493 HPSAs with 35 million residents have ratios at or above 2000:1 and would require 6,478 extra physicians; and 1956 HPSAs with 55.3 million residents have ratios at or above 1500:1 ratios and would require a shift of 14,053 extra physicians.

Conclusion: Shifts of relatively small number of physicians could eliminate most HPSAs and focused policy options like quadrupling the National Health Service Corp could achieve this.