Article Figures & Data
Tables
Percent Race, Ethnicity Number Percent Female African American Asian Hispanic White Other Missing Age, Years Mean (SD) SD = standard deviation. California Family physicians 8,153 20.3 1.8 13.2 4.7 45.4 1.9 33.1 53.1 (12.5) General pediatricians 4,462 44.9 2.1 17.7 3.7 40.0 2.1 34.5 49.1 (10.8) General internists 7,984 23.5 2.1 15.7 2.6 39.8 2.6 37.2 48.9 (11.4) Obstetrician-gynecologists 3,693 27.9 3.9 13.7 3.9 48.5 1.5 28.5 51.8 (11.1) Nurse practitioners 2,509 96.1 3.7 7.0 6.7 78.6 3.1 0.9 46.4 (8.2) Physician assistants 833 54.6 7.8 7.7 15.7 62.4 4.8 1.6 43.5 (8.3) Certified nurse-midwives 419 98.6 4.3 2.9 4.1 84.3 2.7 1.9 45.6 (7.1) Washington Family physicians 2,323 24.8 0.8 6.7 2.0 75.8 7.3 7.4 47.7 (10.3) General pediatricians 637 41.9 0.9 9.7 2.2 69.9 8.5 8.8 46.9 (10.2) General internists 1,164 29.7 0.9 10.1 2.1 68.6 6.9 11.3 44.8 (10.1) Obstetrician-gynecologists 569 33.9 2.1 8.1 1.9 74.9 5.4 7.6 48.4 (10.0) Nurse practitioners 442 92.1 0.9 3.2 1.8 89.6 3.2 1.4 47.1 (7.4) Physician assistants 485 38.8 2.7 5.8 4.5 81.6 4.5 0.8 45.4 (8.8) - Table 2.
Percentage of Clinicians in Each Discipline Practicing in Underserved Areas, by Type of Underserved Area
Rural Area % (95% CI) Vulnerable Population Area % (95% CI) HPSA % (95% CI) CI = confidence interval, HPSA = primary care health profession shortage area. *Percent of state’s population residing in each type of underserved area. P < .001 for comparisons of percentages across disciplines in each state for each type of underserved area. California Population* 13.0 39.0 28.0 Family physicians 13.2 (12.5–13.9) 30.5 (29.5–31.5) 24.2 (23.3–25.1) General pediatricians 6.2 (5.5–6.9) 31.0 (29.6–32.4) 18.6 (17.5–19.7) General internists 5.9 (5.4–6.4) 31.5 (30.5–32.5) 17.9 (17.1–18.7) Obstetrician-gynecologists 6.3 (5.5–7.1) 28.3 (26.8–29.8) 16.9 (15.7–18.1) Nurse practitioners 15.0 (13.6–16.4) 34.4 (32.5–36.3) 26.3 (24.6–28.0) Physician assistants 21.7 (18.9–24.5) 47.7 (44.3–51.1) 35.2 (32.0–38.4) Certified nurse-midwives 15.5 (12.0–19.0) 41.1 (36.4–45.8) 35.3 (30.7–39.9) Washington Population* 24.0 40.0 38.6 Family physicians 23.6 (21.8–25.3) 45.6 (43.5–47.6) 43.5 (41.5–45.6) General pediatricians 14.3 (11.5–17.1) 43.5 (39.6–47.4) 32.8 (29.1–36.5) General internists 13.8 (11.8–15.9) 54.5 (51.6–57.4) 28.4 (25.8–31.1) Obstetrician-gynecologists 13.7 (10.8–16.6) 52.9 (48.7–57.1) 31.6 (27.7–35.5) Nurse practitioners 19.7 (15.9–23.5) 51.8 (47.0–56.6) 37.3 (32.7–42.0) Physician assistants 27.8 (23.7–31.9) 50.3 (45.8–54.7) 42.1 (37.6–46.6) - Table 3.
Percentage of Clinicians in Each Discipline Practicing in Health Professions Shortage Area (HPSA), Stratified by Urban vs Rural Location
Rural Clinicians in a HPSA % (95% CI) Urban Clinicians in a HPSA % (95% CI) CI = confidence interval. California Family physicians 48.8 (45.8–51.8) 20.5 (19.5–21.4) General pediatricians 49.3 (43.3–55.2) 16.6 (15.5–17.8) General internists 49.2 (44.6–53.7) 15.9 (15.1–16.7) Obstetrician-gynecologists 47.0 (40.5–53.5) 14.9 (13.7–16.1) Nurse practitioners 51.1 (46.0–56.1) 22.0 (20.2–23.7) Physician assistants 60.3 (53.1–67.6) 28.3 (24.8–31.8) Certified nurse-midwives 50.0 (37.6–62.4) 32.6 (27.7–37.5) Washington Family physicians 79.2 (75.7–82.7) 32.5 (30.3–34.7) General pediatricians 78.0 (69.0–87.1) 25.3 (21.5–29.0) General internists 78.3 (71.6–84.9) 20.4 (17.9–23.0) Obstetrician-gynecologists 73.1 (62.6–83.6) 25.1 (21.1–29.0) Nurse practitioners 83.9 (75.6–92.2) 25.9 (21.2–30.6) Physician assistants 80.0 (72.9–87.1) 27.4 (22.6–32.2) - Table 4.
Results of Regression Models: Odds Ratios of Practicing in Needy Areas, by Type of Area
Rural Area OR (95% CI) Vulnerable Population Area OR (95% CI) HPSA OR (95% CI) HPSA = health professions shortage area, OR = odds ratio, CI = confidence interval. California Clinician type Family physician 2.24 (1.93–2.60) 1.12 (1.02–1.22) 1.56 (1.41–1.73) General pediatrician 1.02 (0.85–1.23) 1.22 (1.10–1.34) 1.16 (1.03–1.30) General internist 0.93 (0.76–1.09) 1.21 (1.11–1.33) 1.09 (0.98–1.21) Obstetrician-gynecologist 1.0 1.0 1.0 Nurse practitioner 3.17 (2.62–3.84) 1.33 (1.18–1.50) 1.84 (1.61–2.11) Physician assistant 4.75 (3.80–5.92) 2.18 (1.86–2.56) 2.65 (2.23–3.14) Race, ethnicity Asian 0.60 (0.52–0.70) 1.26 (1.17–1.36) 0.80 (0.73–0.88) African American 0.30 (0.20–0.45) 2.74 (2.35–3.19) 1.35 (1.14–1.61) Latino 0.77 (0.63–0.94) 1.90 (1.68–2.14) 1.30 (1.14–1.12) Other 0.92 (0.69–1.22) 1.17 (0.98–1.39) 0.91 (0.74–1.12) White 1.0 1.0 1.0 Sex Female 0.71 (0.63–0.79) 1.02 (0.96–1.09) 0.90 (0.84–0.97) Male 1.0 1.0 1.0 Age (10 years) Years 2.29 (1.71–3.06) 1.05 (0.88–1.25) 1.29 (1.06–1.57) Years2 0.92 (0.89–0.95) 0.99 (0.97–1.01) 0.97 (0.95–0.99) Washington Clinician type Family physician 1.85 (1.42–2.42) 0.71 (0.59–0.86) 1.66 (1.35–2.03) General pediatrician 1.06 (0.75–1.49) 0.66 (0.52–0.84) 1.10 (0.85–1.41) General internist 1.03 (0.76–1.39) 1.15 (0.92–1.42) 0.92 (0.73–1.15) Obstetrician-gynecologist 1.0 1.0 1.0 Nurse practitioner 1.79 (1.25–2.57) 1.12 (0.86–1.47) 1.47 (1.11–1.95) Physician assistant 2.35 (1.70–3.24) 0.90 (0.70–1.16) 1.55 (1.20–2.01) Race, ethnicity Asian 0.39 (0.28–0.55) 1.25 (1.02–1.54) 0.77 (0.62–0.95) African American 0.30 (0.12–0.74) 2.70 (1.57–4.64) 0.60 (0.35–1.05) Latino 1.21 (0.80–1.84) 2.01 (1.39–2.92) 1.67 (1.16–2.39) Other 0.61 (0.45–0.83) 1.93 (1.54–2.40) 0.61 (0.48–0.77) White 1.0 1.0 1.0 Sex Female 0.63 (0.53–0.75) 0.80 (0.70–0.92) 0.71 (0.62–0.82) Male 1.0 1.0 1.0 Age Years 0.72 (0.44–1.20) 0.95 (0.63–1.41) 0.92 (0.61–1.39) Years2 1.03 (0.98–1.08) 1.01 (0.97–1.05) 1.00 (0.96–1.04) Patients in Clinicians’ Practice Who Are Clinicians Practicing in Community Clinics % (95% CI) Medicaid Beneficiaries Mean % (95% CI) Uninsured Mean % (95% CI) Minorities Mean % (95% CI) CI = confidence interval. P < .001 for overall differences across clinician groups for each item. Family physicians 3.0 (0.8–5.2) 9.4 (6.8–12.0) 6.2 (4.6–7.9) 49.3 (42.8–55.8) General pediatricians 4.4 (1.4–7.4) 19.2 (15.0–23.4) 4.8 (3.1–6.5) 58.1 (50.8–65.4) General internists 3.8 (1.0–6.6) 7.1 (5.0–9.3) 4.2 (2.5–5.8) 47.7 (40.5–55.0) Obstetrician-gynecologists 0.01 (0.0–0.2) 13.7 (9.8–17.6) 4.4 (3.3–5.4) 53.1 (44.5–61.7) Nurse practitioners 20.8 18.9–22.7) 25.5 (24.1–27.0) 24.6 (23.0–26.1) 61.5 (59.2–63.8) Physician assistants 14.8 (11.8–17.8) 31.0 (28.3–33.8) 17.1 (14.9–19.2) 65.4 (61.4–69.4) Certified nurse-midwives 17.1 (12.8–21.4) 43.2 (38.7–47.6) 10.7 (8.2–13.2) 66.3 (60.9–71.7)
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