Rural-urban distribution of the U.S. geriatrics physician workforce

Lars E. Peterson, Andrew Bazemore, Elizabeth J. Bragg, Imam Xierali, Gregg A. Warshaw

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

OBJECTIVES: To determine the distribution of geriatricians across the rural-urban continuum from 2000 to 2008 and to compare with primary care physicians in 2008. DESIGN: County-level analysis of physician data from the American Medical Association Physician Masterfile for 2000, 2004, and 2008 merged with U.S. Census data on the number of older (≤65) county residents. Descriptive statistics for each year were stratified according to 2003 Rural Urban Continuum Codes (RUCCs). SETTING: United States. PARTICIPANTS: Physicians in the United States. MEASUREMENTS: Number of physicians per county elderly population. RESULTS: The number of self-identified geriatricians nationwide increased from 5,157 to 7,412 from 2000 to 2008. The number of geriatricians increased in each RUCC level, with nearly 90% of geriatricians residing in urban areas in all years. In 2008, the number of geriatricians per 10,000 older adults declined as rurality increased (from 1.48 in the most-urban areas to 0.80 in the most rural). General internal medicine physicians are more plentiful in urban counties and declined as rurality increased (from 27.29 to 3.85 per 10,000 older adults in 2008). In contrast, family physicians were more evenly distributed with the elderly population across the rural-urban continuum (22.02 to 14.27 per 10,000 older adults in 2008). CONCLUSION: Small numbers of geriatricians combined with a growing elderly population poses a challenge and an opportunity. Healthcare systems and policy-makers will need to modify care models to better use the skill of geriatricians in concert with other providers to provide quality care for older rural and urban Americans.

Original languageEnglish (US)
Pages (from-to)699-703
Number of pages5
JournalJournal of the American Geriatrics Society
Volume59
Issue number4
DOIs
StatePublished - Apr 1 2011
Externally publishedYes

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Geriatrics
Physicians
Quality of Health Care
Family Physicians
American Medical Association
Primary Care Physicians
Rural Population
Censuses
Internal Medicine
Geriatricians
Administrative Personnel
Population
Delivery of Health Care

Keywords

  • geriatrics
  • medicare
  • physician workforce
  • rural
  • urban

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Rural-urban distribution of the U.S. geriatrics physician workforce. / Peterson, Lars E.; Bazemore, Andrew; Bragg, Elizabeth J.; Xierali, Imam; Warshaw, Gregg A.

In: Journal of the American Geriatrics Society, Vol. 59, No. 4, 01.04.2011, p. 699-703.

Research output: Contribution to journalArticle

Peterson, Lars E. ; Bazemore, Andrew ; Bragg, Elizabeth J. ; Xierali, Imam ; Warshaw, Gregg A. / Rural-urban distribution of the U.S. geriatrics physician workforce. In: Journal of the American Geriatrics Society. 2011 ; Vol. 59, No. 4. pp. 699-703.
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abstract = "OBJECTIVES: To determine the distribution of geriatricians across the rural-urban continuum from 2000 to 2008 and to compare with primary care physicians in 2008. DESIGN: County-level analysis of physician data from the American Medical Association Physician Masterfile for 2000, 2004, and 2008 merged with U.S. Census data on the number of older (≤65) county residents. Descriptive statistics for each year were stratified according to 2003 Rural Urban Continuum Codes (RUCCs). SETTING: United States. PARTICIPANTS: Physicians in the United States. MEASUREMENTS: Number of physicians per county elderly population. RESULTS: The number of self-identified geriatricians nationwide increased from 5,157 to 7,412 from 2000 to 2008. The number of geriatricians increased in each RUCC level, with nearly 90{\%} of geriatricians residing in urban areas in all years. In 2008, the number of geriatricians per 10,000 older adults declined as rurality increased (from 1.48 in the most-urban areas to 0.80 in the most rural). General internal medicine physicians are more plentiful in urban counties and declined as rurality increased (from 27.29 to 3.85 per 10,000 older adults in 2008). In contrast, family physicians were more evenly distributed with the elderly population across the rural-urban continuum (22.02 to 14.27 per 10,000 older adults in 2008). CONCLUSION: Small numbers of geriatricians combined with a growing elderly population poses a challenge and an opportunity. Healthcare systems and policy-makers will need to modify care models to better use the skill of geriatricians in concert with other providers to provide quality care for older rural and urban Americans.",
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