Arizona Center for Rural Health, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ.
Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ.
Fam Med. 2023 Jan;55(1):20-26. doi: 10.22454/FamMed.55.619324.
Physician location is an important element of health care access. However, physician shortages and disparities in geographic distribution exist. This study examines physician locations, relocation patterns, and factors associated with relocating.
We used Arizona licensure data and rural-urban commuting area (RUCA) codes to identify Arizona physicians and their office or mailing address locations. Our sample included Arizona physicians estimated to be younger than 70 years of age who had an active license between in 2014 and 2019. We used multivariable logistic regression to assess physicians' adjusted odds of relocating in Arizona by RUCA code, primary care status, age, gender, and medical education location.
We identified 11,202 Arizona physicians in our sample, 33% of whom changed practice addresses within Arizona between 2014 and 2019. Primary care physicians (PCPs) in large rural areas had lower odds of relocating in Arizona (0.62, 95% CI 0.43-0.90) than PCPs in urban areas. Compared to 64-69-year-old physicians, those less than 34 and 34-43 years old had statistically higher odds of relocating within Arizona.
Primary care status and rurality are important factors consider to understand physician relocation patterns. We found that a substantial number of Arizona physicians relocated within Arizona between 2014 and 2019, and few of those who relocated (2%) moved to a more rural area.
医生的工作地点是医疗服务可及性的一个重要因素。然而,存在着医生短缺和地理分布不均的问题。本研究旨在考察医生的工作地点、迁移模式以及与迁移相关的因素。
我们使用亚利桑那州的执照数据和农村-城市通勤区(RUCA)代码来识别亚利桑那州的医生及其办公室或邮寄地址。我们的样本包括预计年龄在 70 岁以下,并且在 2014 年至 2019 年期间拥有有效执照的亚利桑那州医生。我们使用多变量逻辑回归来评估医生在 RUCA 代码、初级保健状态、年龄、性别和医学教育地点方面在亚利桑那州迁移的调整后几率。
我们在样本中确定了 11202 名亚利桑那州医生,其中 33%的人在 2014 年至 2019 年期间在亚利桑那州内改变了行医地址。与城市地区的初级保健医生(PCP)相比,大型农村地区的 PCP 在亚利桑那州内迁移的几率较低(0.62,95%CI 0.43-0.90)。与 64-69 岁的医生相比,年龄小于 34 岁和 34-43 岁的医生在亚利桑那州内迁移的几率更高。
初级保健状态和农村地区是理解医生迁移模式的重要因素。我们发现,2014 年至 2019 年间,相当数量的亚利桑那州医生在亚利桑那州内迁移,而迁移的医生中(2%)很少有人迁移到更偏远的地区。