Primary care, specialty care, and life chances

Research output: Contribution to journalArticle

Abstract

The relationship between the availability of primary care and specialty care and certain life chance indicators such as mortality rates and life expectancy is analyzed using the multiple regression procedure. Dependent variables are life chance indicators; independent variables were selected based on Starfield's and Blum's health determinant models and include socioeconomic environment, lifestyles, demographics, and medical care. The author also examines the rankings of states in terms of these indicators, using Spearman's rho coefficient. Among the medical care variables, primary care is by far the most significant variable related to better health status, correlating with lower overall mortality, lower death rates due to diseases of the heart and cancer, longer life expectancy, lower neonatal death rate, and lower low birth weight. In contrast, the number of specialty physicians is positively and significantly related to total mortality, deaths due to heart diseases and cancer, shorter life expectancy, higher neonatal mortality, and higher low birth weight. From a policy perspective, a likely implication is to reorient the medical profession from its current expensive, clinically based, treatment-focused practice to a more cost-effective, prevention-oriented primary care system.

Original languageEnglish (US)
Pages (from-to)431-458
Number of pages28
JournalInternational Journal of Health Services
Volume24
Issue number3
StatePublished - 1994
Externally publishedYes

Fingerprint

Primary Health Care
mortality
life expectancy
Life Expectancy
Mortality
death rate
Heart Neoplasms
medical care
Low Birth Weight Infant
cancer
heart disease
health status
Infant Mortality
ranking
profession
physician
Health Status
determinants
Life Style
Heart Diseases

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Primary care, specialty care, and life chances. / Shi, Leiyu.

In: International Journal of Health Services, Vol. 24, No. 3, 1994, p. 431-458.

Research output: Contribution to journalArticle

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