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Physician Supply and Preventable Hospitalizations by County

Thirty-four California counties (58.6 percent) have low rates of physicians who care for patients with pneumonia and have high rates of preventable hospitalizations for community-acquired pneumonia.

Why publish Physician Supply and Preventable Hospitalizations by County?

  • Preventable hospitalizations for select health conditions are used to gauge patients’ access to quality primary health 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 visualization 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.
  • A list of physician primary area of medical focus for each preventable hospitalization type is located below, in the “How HCAI Created This Product” section.

Key Findings

  • The dark orange counties have low physician rates and high preventable hospitalization rates. Hypertension (high blood pressure) has the fewest dark orange counties, with 19 (32.8 percent) counties.
  • The dark blue counties have high physician rates and low preventable hospitalization rates; Asthma in Young Adults (Age 18 to 39) had the greatest number of blue counties, with 17 (29.3 percent) counties.
  • The central valley counties experienced high preventable hospitalizations and low physician supply for all indicators except hypertension.

Note: This visualization features additional information in the tooltip, which is shown when you hover over a county.

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.
  • The Physician by Specialty dataset contains aggregated responses from the Medical Board of California and Osteopathic Board of California physician survey incorporated into the license renewal process, which is limited to physicians whose license was in “Current” or “License Renewal Fees Paid” status as of December 31, 2020.
  • 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 medical focus from the Physicians by Specialty and Patient Care Hours dataset.
Prevention Quality IndicatorPhysician Primary Area of Medical Focus
Chronic Obstructive Pulmonary Disease (COPD) (chronic bronchitis or emphysema) or Asthma in Older Adults (ages 40 and over; PQI#5)Allergy & Immunology, Family Medicine, General Practice, Geriatric Medicine, Internal Medicine, Pulmonary, and Radiology
Hypertension (high blood pressure; PQI#7)Cardiology, Emergency Medicine, Family Medicine, General Practice, Geriatric Medicine, Internal Medicine, and Nephrology
Heart Failure (PQI#8)Cardiology, Emergency Medicine, Family Medicine, General Practice, Geriatric Medicine, Internal Medicine, and Pulmonary
Community-Acquired Pneumonia (PQI#11)Family Medicine, General Practice, Geriatric Medicine, Infectious Disease, Internal Medicine, Pathology, and Pulmonary
Urinary Tract Infection (UTI; PQI#12)Family Medicine, General Practice, Internal Medicine, Obstetrics and Gynecology, and Urology
Asthma in Younger Adults (ages 18-39; PQI#15)Allergy & Immunology, Family Medicine, General Practice, Internal Medicine, Pulmonary, and Radiology
Diabetes (PQI#93)Endocrinology, Cardiology, Neurology, Family Medicine, General Practice, Geriatric Medicine, Internal Medicine, Nephrology, and Ophthalmology
View Underlying Data – Preventable Hospitalizations
View Underlying Data – Physicians by Specialty and Patient Care Hours

Additional Information

Topic: Healthcare Quality / Healthcare Workforce
Source Link: AHRQ Quality Indicators / Healthcare Workforce Data
Citation: HCAI – Prevention Quality Indicators (PQI) Rates of Preventable Hospitalizations for Selected Medical Conditions by County (LGHC Indicator) and Physicians by Specialty and Patient Care Hours, 2020
Temporal Coverage: 2020
Spatial/Geographic Coverage: Statewide, County
Frequency: Annually