The U.S. healthcare system is generally centered around hospitals and specialty care. But the value of primary care has remained somewhat unclear, in part due to limited research.
A new Northwestern Medicine study directly compared the quality and experience of outpatient care between adults with or without primary care.
It found that Americans with primary care received significantly more high-value healthcare -- such as recommended cancer screenings and flu shots -- and reported better patient experience and overall healthcare access, compared to those who don't have a primary care physician.
To determine if the study participants had primary care, the researchers asked them to provide the name of a physician to whom they "usually go if (they) are sick or need advice about health." If they were able to identify such a physician who practiced outside of the emergency department, they were considered to have a "usual source of care."
The participants also needed to answer "yes" to receiving the four "C's" of primary care: first contact (regarding new health problems); comprehensive care (preventative care such as general checkups and immunizations); continuous care; and coordinated care (involving referrals to other health professionals when needed).
The investigators found that even though all respondents received a similar amount of care, Americans with primary care received significantly more "high-value" services, such as recommended cancer screenings, diagnostic and preventive testing, diabetes care and counseling.
Those with primary care also reported better healthcare access and experience, compared to those without.
But patients with primary care were also slightly more likely to receive low-value care -- in particular, unnecessary antibiotics.
Overall, the authors concluded that policymakers and health system leaders seeking to increase value should consider increasing investments in primary care.
Finding access to primary care is more of a challenge than it used to be, given that the numbers of primary care physicians are on the decline in both rural and non-rural settings.
The number of nurse practitioners, on the other hand, is on the rise, according to some studies, resulting in some diverse practice care teams.