226604 Spatial Modeling of Health Care Workforce in Georgia

Tuesday, November 9, 2010 : 11:10 AM - 11:30 AM

Imam M. Xierali, PhD , Robert Graham Center, Washington, DC
Robert Phillips, MD, MPH , Robert Graham Center, American Academy of Family Physicians, Washington, DC
Andrew Bazemore, MD, MPH , Robert Graham Center, Washington, DC
Context: The health care workforce is geographically mal-distributed resulting in unequal access to health care. This study examines the neighborhood factors affecting the distribution of health care workforce, namely, physicians, physician assistant, and nurse practitioner in Georgia.

Objective: To show that health care workforce distribution is affected by neighborhood attributes – not only within neighborhoods but also in areas adjoining.

Design: Health care workforce distribution is predicted by the socioeconomic attributes of and spatial relationship among census tracts in a spatial regression model. Spatial relationship is explicitly measured as a. distance from a census tract to the nearest urban center, b. spatial dependence among census tracts, and c. regional effect. The research utilizes a mixed-order spatial weight matrix to understand the spatial effects in health care workforce distribution.

Data: Data come from the 2009 American Medical Association Master File, the National Provider Identifier (NPI) database, Census 2000, and Claritas Population Estimate 2009.

Results: The preliminary results show that at the census tract level, the size of health care workforce are associated with proportions of population with Higher Education Degree (coefficient= 2.603; p-value= 0.0000), the elderly 65 or over (coefficient=0.927, p-value= 0.0000), and non-shortage area status (HPSA coefficient=-1.9140, p-value= 0.0004). There is also a statistically significant positive spatial effect (lambda coefficient=0.1525, p-value= 0.0000).

Conclusion: In considering risk of poor access to health care workforce in an area, the attributes of surrounding areas should also be considered. The findings can contribute to efforts to resolve poor health care workforce distribution.

Learning Areas:
Provision of health care to the public
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
To demonstrate that health care workforce distribution is affected by neighborhood attributes – not only within the neighborhood but also in areas adjoining

Keywords: Access to Health Care, Workforce

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Health Geographer and Research Scientist at the Robert Graham Center. Previously, I was a Statistical Analyst at Georgia Division of Public Health, actively participating in enterprise GIS management and applying geographic information systems and spatial statistics in public health policy research. My research interests are in spatial disparities in health and health care, geospatial technologies for health applications, statistical modeling and spatial statistics. I am particularly interested in combining geospatial analytical tools and statistical modeling to study the spatial relationships between health and environment, health outcomes, and primary care access and delivery.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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