Physician Supply and Preventable Hospitalizations by County, 2023

Why Publish Physician Supply and Preventable Hospitalizations by County?#

• Preventable hospitalizations for select health conditions are used to gauge patients’ access to quality outpatient care, particularly primary care. Counties and groups of patients with more preventable hospitalizations, measured as a percent of all hospital discharges, typically have less access to quality primary health care.
• County-wide access to health care may be reduced when there is a lack of physicians to prevent and treat health conditions (e.g., community acquired pneumonia and hypertension), which typically increases the number of preventable hospital admissions in that county.
• The map below shows counties and their associated preventable hospitalization rates alongside their rates of physicians actively practicing in the county, by primary care and condition-specific specialty. This provides a way to identify counties that may need additional physicians to care for their residents with certain health conditions to prevent them from being hospitalized.
• The anticipated retirement of practicing physicians dashboard provides the percentage of practicing physicians providing direct patient care that treat a specific condition retiring in 0-5 years by county. This may indicate counties where there could be a greater need for physicians in the next 5 years.
• A list of physician primary areas of practice or specialties for each preventable hospitalization type is located below, in the “How HCAI Created This Product” section.

How HCAI Created This Product#

• To identify hospitalizations that may have been prevented if patients had access to high-quality outpatient care, the Agency for Healthcare Research and Quality (AHRQ) created the Prevention Quality Indicators (PQIs). These PQIs were used to identify preventable hospitalizations for this analysis.
• The PQI Observed Rates were used. See the PQI section of the HCAI website and the AHRQ website for more information.
• Counties with rates of physicians who prevent, diagnose and/or treat specific conditions related to preventable hospitalizations which are higher than the statewide rate are classified as “high physician supply” counties. Counties with lower physician rates than the statewide rate are classified as “low physician supply” counties. Counties with preventable hospitalization rates higher than the statewide rate are classified as “high preventable hospitalization” counties, while counties with rates lower than the statewide rate are classified as “low preventable hospitalization” counties.
• Licensure data was collected by the Department of Consumer Affairs; all data presented represents a snapshot of the active licensee population on July 3, 2024.
• This product is based on HCAI Health Workforce License Renewal Survey data; all data presented as of July 3, 2024. The responses to these surveys were adjusted using cell based weighting to create estimates of the full population. Decline to state answers were excluded from the data for each visualization, as well as licensees who did not report actively working in a position that requires their license, or were not currently working but seeking work in their field at the time of renewal. Physician licenses who reported “None” for average number of hours per week spent on direct patient care were excluded from this analysis.
• Practicing physicians are active physician licensees who provide at least one hour of direct patient care.
• The table below was used to identify which physicians would be needed to prevent and/or treat each PQI, based on their primary area of practice (specialty). Physicians could be counted under multiple PQIs.

• Regions were defined by the California Health Interview Survey (CHIS) and are listed below: