Indicator of Local PCP Supply | Tertile of Municipal Population Density | % (No.) of Blocks | RR (95% CI)a | P Value | Tertile of Social Deprivation Index | % (No.) of Blocks | RR (95% CI)a | P Value |
---|---|---|---|---|---|---|---|---|
Blocks has ≥1 PCP … | ||||||||
… present | Low 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) | <.001 | High 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 visits | Low Medium High | 26.0 (450) 38.0 (663) 51.6 (892) | ref 1.46 (1.31-1.62) 1.98 (1.79-2.18) | <.001 | High 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 visits | Low Medium High | 14.1 (244) 17.9 (311) 26.2 (453) | ref 1.26 (1.06-1.50) 1.84 (1.58-2.14) | <.001 | High 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 inhabitants | Tertile of Municipal Population Density | Mean (SD) | IRR (95% CI)b | P Value | Tertile of Social Deprivation Index | Mean (SD) | IRR (95% CI)b | P Value |
---|---|---|---|---|---|---|---|---|
… present | Low 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) | .001 | High 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 visits | Low 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) | <.001 | High 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 visits | Low 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) | .02 | High 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.