Physician offices have greater potential to affect the health of the largest number of people across multiple socioeconomic levels than any other care delivery setting, according to new research.
In the July 29 issue of Annals of Family Medicine, researchers from the Washington, D.C.-based Robert Graham Center : Policy Studies in Family Practice and Primary Care examine the impact of socioeconomic status and availability of health insurance on the likelihood of seeking care.
They find that access to care is least equitable for racial and ethnic minorities in physician offices, when compared to outpatient clinics, emergency departments, hospitals and homes. People without a usual care source are less likely to seek any sort of healthcare and those without insurance have lower rates of care in all settings other than EDs.
"From a policy perspective, having a usual source of care and health insurance is the most amenable health arrangement to intervention," the report says.
According to the research, African-Americans seek care in EDs, hospitals and homes at the same rate as whites in the United States, but blacks are less likely to visit doctors' offices or outpatient hospital clinics. Rates of emergency visits for Hispanics and Native Americans also are higher than for other groups.
Additionally, the report says, poor and rural Americans seek more care in settings other than physician offices than do those with higher incomes and in urban areas. Education level also has a strong bearing on the decision whether to visit a private doctor's office.
"After controlling for all of these variables, there is one healthcare setting in which there is unequal access: the physician's office for people of color and Hispanics," says Larry Green, M.D., Graham Center director. "Physicians' offices are the single largest platform of delivery of healthcare in the United Statres. The designs and infrastructures that sustain them will remain central to achieving important policy objectives."