People who live in areas where primary care provider shortages are more severe are at higher risk of requiring emergency surgery, according to new findings from a study led by researchers at Michigan Medicine in Ann Arbor.
To conduct the study, researchers analyzed data from patients on Medicare who underwent surgeries for conditions where a scheduled operation is preferably planned, though may be delayed when access to primary care providers is limited, including colectomy for colon cancer, abdominal aortic aneurysm repair and incision hernia repair. They analyzed outcomes in areas the government has deemed Health Professional Shortage Areas from 2015 to 2019, and separated the areas into five levels of severity.
For patients living in areas considered to have more severe levels of provider shortages, almost 40% had operations on an emergency basis, relative to 30% for those living in areas with the least severe shortages, according to the findings, published in the March issue of Health Affairs.
Two other outcomes to note:
- About 15% of patients in severe shortage areas had a higher risk of more serious complications, relative to 12% in areas where shortages were less dire.
- Patients in areas with high levels of provider scarcity faced a higher risk of hospital readmission after surgery (15.7% versus 13.5%).
"A scheduled surgical case is always better than an emergency case in outcomes, costs and impact on the patient's life, so the role of the primary care provider in identifying a potential issue, and referring a patient for diagnostic imaging and surgery, can make a major difference in addressing an urgent problem before it becomes an emergency," Sara Schaefer, MD, lead study author, said in a news release.
In the U.S., more than 180 areas have been federally designated as primary care shortage areas for at least 40 years.