THURSDAY, Jan. 31, 2019 — Receipt of primary care is associated with significantly more high-value care, slightly more low-value care, and a better health care experience, according to a study published online Jan. 28 in JAMA Internal Medicine.
David M. Levine, M.D., M.P.H., from Brigham and Women’s Hospital in Boston, and colleagues compared propensity score-weighted quality and experience of care for 49,286 adults with and 21,133 adults without primary care who participated in the Medical Expenditure Panel Survey.
The researchers found that U.S. adults with or without primary care had the same mean numbers of outpatient, emergency department, and inpatient encounters annually after propensity score weighting. Those with primary care filled more prescriptions (mean, 14.1 versus 10.7) and were more likely to have a routine preventive visit in the previous year (mean, 72.2 versus 57.5 percent). Americans with primary care received more high-value care in four of five composites from 2012 to 2014; 78 versus 67 percent received high-value cancer screening. Low-value care was received at similar frequencies for Americans with and without primary care on three of four composites; those with primary care received more low-value antibiotics (59 versus 48 percent). Respondents with primary care reported significantly better health care access and experience. Physician communication was highly rated among 64 and 54 percent of those with and without primary care, respectively.
“Policymakers and health system leaders seeking to improve value should consider increasing investments in primary care,” the authors write.
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Posted: January 2019
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