Primary care and preventive medicine include services like immunizations, cancer screenings,
chronic disease management, and health education. A health system built around strong primary
care reduces avoidable ER visits and hospitalizations, improves health outcomes, lowers costs,
and promotes equity.
But today, over 77 million people live in communities officially designated as primary care shortage areas.
But today, over 77 million people live in communities officially designated as primary care shortage areas.
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In 24 states, over a quarter of the population lives in primary care shortage areas.
Populations living in these designated shortage areas often experience significant health disparities,
as limited access to health care results in higher rates of preventable disease and poor health outcomes.
In these shortage areas, the population to primary care provider ratio falls below 3,500 to 1
(3,000 to 1 if there are unusually high needs in the community).
Within these Primary Care Shortage Areas, only about half of the population's primary care needs are met.
Percent of Need Met is computed by dividing the number of physicians available to serve the population of the area, group, or facility by the number of
physicians that would be necessary to eliminate the primary are HPSA (based on a ratio of 3,500 to 1 (3,000 to 1 where high needs are indicated)).
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When people don’t have access to routine care, chronic and acute illnesses get worse. And they show up in the ER.
Non-trauma visits have stayed relatively steady since 2016 — but they remain a major share of emergency care.
Primary care shortages don’t necessarily drive more people to the ER —
but they often mean that people arrive in worse shape.
When outpatient care is delayed or inaccessible, manageable conditions accumulating disease burden before reaching emergency care.
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We don’t have national data on how severe emergency visits are getting,
but California, the most populous state, gives us a clear warning sign.
It’s not that more people are coming to the ER with preventable conditions —
it’s that those who do are sicker than they used to be.
In California, a growing share of ER patients are in serious condition.
Between 2012 and 2021, the share of emergency department visits classified as severe or critical in California
rose by over 30%.
This is just one example of how gaps in one part of the system show up somewhere else.
When people can’t get the care they need early on, it eventually becomes an emergency.