Table 2.

Inequalities in PCP Supply by Population Density and by Deprivation Level, and Variation of Inequalities Across Indicators (N = 5,188 Census Blocks)

Indicator of Local PCP SupplyTertile of Municipal Population Density% (No.) of BlocksRR (95% CI)aP ValueTertile of Social Deprivation Index% (No.) of BlocksRR (95% CI)aP Value
Blocks has ≥1 PCP …
… presentLow
Medium
High
41.6 (715)
56.8 (987)
69.6 (1,202)
ref
1.36 (1.27-1.46)
1.67 (1.56-1.80)
<.001High
Medium
Low
49.7 (850)
50.0 (854)
68.2 (1,200)
ref
1.01 (0.94-1.08)
1.33 (1.25-1.41)
<.001
… registering patients for office visitsLow
Medium
High
26.0 (450)
38.0 (663)
51.6 (892)
ref
1.46 (1.31-1.62)
1.98 (1.79-2.18)
<.001High
Medium
Low
32.2 (550)
33.1 (565)
50.5 (889)
ref
1.03 (0.94-1.14)
1.57 (1.42-1.74)
<.001
… registering patients for home visitsLow
Medium
High
14.1 (244)
17.9 (311)
26.2 (453)
ref
1.26 (1.06-1.50)
1.84 (1.58-2.14)
<.001High
Medium
Low
13.5 (230)
16.2 (277)
28.5 (501)
ref
1.20 (1.02-1.42)
2.12 (1.81-2.48)
<.001
Number of PCPs … per block per 10,000 inhabitantsTertile of Municipal Population DensityMean (SD)IRR (95% CI)bP ValueTertile of Social Deprivation IndexMean (SD)IRR (95% CI)bP Value
… presentLow
Medium
High
  5.45 (20.6)
  7.05 (10.7)
10.3 (21.6)
ref
1.06 (0.95-1.18)
1.29 (1.13-1.48)
.001High
Medium
Low
  6.71 (26.2)
  5.90 (11.0)
10.1 (14.4)
ref
1.13 (0.95-1.33)
1.47 (1.28-1.68)
<.001
… registering patients for office visitsLow
Medium
High
  1.97 (5.11)
  3.06 (5.93)
  4.45 (6.89)
ref
1.19 (1.03-1.38)
1.67 (1.44-1.93)
<.001High
Medium
Low
  2.42 (5.34)
  2.24 (5.70)
  4.50 (6.92)
ref
1.02 (0.89-1.18)
1.60 (1.40-1.82)
<.001
… registering patients for home visitsLow
Medium
High
  0.93 (3.33)
  1.12 (3.24)
  1.91 (15.2)
ref
0.88 (0.70-1.11)
1.28 (1.02-1.60)
.02High
Medium
Low
  1.18 (15.2)
  1.00 (3.37)
  1.78 (3.76)
ref
1.13 (0.83-1.54)
1.82 (1.31-2.54)
<.001
  • IRR = incidence rate ratio; PCP = primary care physician; ref = reference group; RR = relative risk.

  • Notes: The least dense and the most deprived tertiles are the reference groups. For example, patients in the least deprived vs most deprived tertile were 33% more likely to have access to at least 1 PCP (RR = 1.33), 57% more likely to have access to at least 1 PCP willing to register a new patient for office visits (RR = 1.57), and 112% more likely to have access to at least 1 PCP willing to register a new patient for ongoing home visits (RR = 2.12). All interactions of indicators with tertiles were statistically significant (P <.001).

  • a RRs were calculated by a univariate log binomial mixed model with a random intercept and 2 levels (block level and municipality level, to take into account possible municipal policies related to the primary care supply).

  • b IRRs were calculated by a univariate Poisson mixed model with a random intercept and 2 levels (block level and a municipality level, to take into account possible municipal policies related to the primary care supply). The offset is the number of inhabitants per census block.