acase@tulane.edu / Background: For the past two decades, Louisiana’s health status has ranked among the lowest in the nation. In 2009, Louisiana was ranked 47th in the nation which indicated marginal improvements from their 49th position in 2008. 1, 2 In addition, the 2009 Commonwealth State Scorecards Report ranked the Louisiana health system performance, in terms of health outcomes, among the poorest in the nation.One reason for this disparity could be attributed to shortages of physicians and other healthcare resources in the state. These shortages were exacerbated by the damage done by the 2005 hurricanes to hospitals and physicians’ practices in New Orleans, and throughout the state.3 Today, 86 percent of Louisiana parishes are designated health professional shortage areas by the Health Resources and Services Administration Shortage Designation Branch (HRSAS). 4 Specifically, 126 areas in Louisiana are considered as primary care shortage areas. 5 Louisiana is ranked 6th in the nation in percent of the population lacking access to primary care. 5According to the Medical Education Commission, approximately 40 percent of Louisiana’s medical school graduates and physicians leave the state after completing their medical residencies. 6 Study Design: Using data from the 2006-2007 Louisiana State Board of Medical Examiners (LSBME) providers’ data set and the 2007-2008 Blue Cross Blue Shield (BCBS) of Louisiana providers’ data to report active physicians by specialty and location in the state, this cross-sectional study analyzed disparities in statewide health system performance, measured by mortality amenable to healthcare (MAHC). Age-adjusted standardized mortality rates (ASMR) from all conditions amenable to healthcare were derived and extracted from the Centers for Disease Control and Prevention (CDC) The Distribution of Physician Workforce in Louisiana: Implications for Outcomes of Care Compressed Mortality File (CMF).7 The CMF is a county-level national mortality and population database spanning the years 1968-2006. The model controlled for sociodemographic factors and health care resources available in the different parishes. Population data were obtained from the 2006-2007 county-specific Area Resource File (ARF). The unit of analysis was the parish. Results: Louisiana is facing a maldistribution of physicians by specialty (primary care vs. specialty care) and geography. Furthermore, throughout Louisiana, health system performance as measured by ASMR from all conditions amenable to healthcare varied widely. Conclusion: Variations in parish physician supply did not explain variations in MAHC. Rather, significant associations were found between socio-economic factors and MAHC / 1 / Maysoun Dimachkie Masri
| Identifer | oai:union.ndltd.org:TULANE/oai:http://digitallibrary.tulane.edu/:tulane_76115 |
| Date | January 2010 |
| Contributors | Masri, Maysoun Dimachkie (author), Campbell, Claudia (Thesis advisor), School of Public Health & Tropical Medicine Global Health Management and Policy (Degree granting institution) |
| Publisher | Tulane University |
| Source Sets | Tulane University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | electronic, 226 |
| Rights | No embargo, Copyright is in accordance with U.S. Copyright law. |
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