Biomaterial Database

Medicaid participation among urban primary care physicians. 1997

J D Perloff, and P R Kletke, and J W Fossett, and S Banks

School of Social Welfare, SUNY, Albany, NY 12222, USA.

OBJECTIVE This article describes Medicaid participation among office-based primary care physicians in cities and examines its determinants. METHODS Data used in this study were collected through the 1993 and 1994 American Medical Association Socioeconomic Monitoring System telephone surveys. The sample includes 1,300 primary care physicians. Our multivariate model includes a variety of personal, practice, community, and policy factors thought to influence participation. Logistic regression was used to examine determinants of accepting any Medicaid patients and ordinary least square regression was used to examine determinants of the extent of participation among participants. RESULTS The authors found that 19% of respondents did not participate in Medicaid and 62% had practices with 9% or fewer Medicaid patients. Multivariate analyses indicated that Medicaid payment levels were not associated with observed patterns of Medicaid participation. Community sociodemographic characteristics and demand from Medicaid-eligibles, by contrast, play a significant role in influencing observed levels of participation. CONCLUSIONS Strategies other than raising Medicaid payment levels will be needed to achieve equitable access to office-based primary care for the poor residing in cities.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008484	Medicaid	Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.	Dental Medicaid Program,Medical Assistance, Title 19,Dental Medicaid Programs,Medicaid Program, Dental,Medicaid Programs, Dental,Program, Dental Medicaid,Programs, Dental Medicaid
D010821	Physicians, Family	Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.	Family Physician,Family Physicians,Physician, Family
D011320	Primary Health Care	Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)	Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D012051	Reimbursement Mechanisms	Processes or methods of reimbursement for services rendered or equipment.	Mechanism, Reimbursement,Mechanisms, Reimbursement,Reimbursement Mechanism
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000553	Ambulatory Care	Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.	Outpatient Care,Outpatient Health Services,Clinic Visits,Health Services, Outpatient,Outpatient Services,Services, Outpatient Health,Urgent Care,Care, Ambulatory,Care, Outpatient,Care, Urgent,Cares, Urgent,Clinic Visit,Health Service, Outpatient,Outpatient Health Service,Outpatient Service,Service, Outpatient,Service, Outpatient Health,Services, Outpatient,Urgent Cares,Visit, Clinic,Visits, Clinic
D014481	United States	A country in NORTH AMERICA between CANADA and MEXICO.
D014505	Urban Population	The inhabitants of a city or town, including metropolitan areas and suburban areas.	Urban Residence,Urban Spatial Distribution,Distribution, Urban Spatial,Distributions, Urban Spatial,Population, Urban,Populations, Urban,Residence, Urban,Urban Populations,Urban Residences,Urban Spatial Distributions