Alleviating physician shortages may prolong life expectancy of population

Increasing the number of primary care physicians (PCPs) in areas with fewer PCPs per population can substantially improve life expectancy, suggests a recent study.

“Prior studies have reported that greater numbers of PCPs per population are associated with reduced population mortality,” the authors said.

Generalized additive models, mixed-effects models, and generalized estimating equations were used in this study to assess how alleviating PCP shortages might change life expectancy and mortality in 3,104 US counties from 2010 to 2017. Outcomes measured were age-adjusted life expectancy, all-cause mortality, and mortality due to cardiovascular disease, cancer, infectious disease, respiratory disease, and substance use or injury.

People living in counties with <1 physician per 3,500 persons in 2017 had a mean life expectancy that was 310.9 days shorter than for those living in counties above that threshold. However, increasing the density of PCPs above the 1:3,500 threshold in low-density counties (n=1,218) could potentially increase mean life expectancy by 22.4 days (median, 19.4 days, 95 percent confidence interval [CI], 0.9–45.6). These counties would need a total of 17,651 PCPs, or about 14.5 more physicians per shortage county.

In counties with <1 physician per 1,500 persons (n=2,626), reaching the 1:1,500 threshold could increase life expectancy by 56.3 days (median, 55.6 days, 95 percent CI, 4.2–105.6). These counties would then require 95,754 more PCPs, or nearly 36.3 more physicians per shortage county.

This study was limited by some projections that were based on extrapolations of the actual data, according to the authors.