234799 District of Columbia Primary Care Needs Assessment (DCPC): An analytical and quantitative method for determining community-based need and demand for primary care

Monday, October 31, 2011: 12:35 PM

Jacob Andoh, MS, MPH, CPM, PhD(cand) , Department of Human Services/Family Services Administration, District of Columbia Government, Washington, DC
This study, District of Columbia Primary Care Needs Assessment (DCPC), analyzed over a twenty year period from 1985 to 2004, the need and demand for primary care using standard and epidemiologically innovative statistical measures for physician distributions and socio-demographic characteristics in the District of Columbia (DC). The study answered the question: Using U.S census-based small area aggregations, Census Tract Groupings (CTGs), that are not zip-code areas or legislative/political boundaries, can a multivariate predictive model be developed using physician ratios, primary care service index (PCSI) and composite need scores (CNS) to explain variations in primary care visits? Primary care priority scores (PCPS) were calculated, analyzed and presented for CTGs in the District of Columbia over the twenty-year period, 1985 to 2004. Results indicated that the abundant supply of DC-based physicians indicated by decreasing population per physician ratios of 239 (1985) to 146 (2004) appear to be a long-term trend. As raw physician counts increased, the ratio of satisfied visits to visits demanded decreased, from 2.62 (1985) to 1.80 (2004). This result appears to indicate that, due to inequities in distribution of primary care physicians in DC's small areas, the increasing numbers of primary care physicians were by themselves, not sufficient to address the city's overall primary care visits need. Epidemiological profiles and primary care analytical methods appear to be useful for small area analysis of urban health and socio-economic characteristics. Physician rates per 1,000 population may be a necessary but not sufficient statistic for estimating urban primary health care needs.

Learning Areas:
Administration, management, leadership
Biostatistics, economics
Program planning
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Describe one or more analytical methods necessary for quantitatively assessing the need and demand for primary care in a well-defined geographical or local community. 2. Demonstrate the use of US census tracts to define and create census tract groupings as rational service areas for primary care analysis and planning. 3. Compare the data and analytic roles and responsibilities of the "five P's" (planners, policymakers, primary care practitioners/physicians, other providers, and the public) in designing effective primary care delivery systems.

Keywords: Methodology, Needs Assessment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the designer, researcher, data analyst and author of this analytical work and paper to be presented at the 139th APHA meeting and conference.
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.