ArticleHealth services research2020
Differences in referral patterns for rural primary care physicians from 2005 to 2016.
Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Article
- Patient-specific and provider-specific predictors of urgent care referral to dermatology: A retrospective cohort and survey study.JAAD international · 2026Article
- Bound in Breadth: Linking a Rural Health Pathway to Family Medicine Careers.PRiMER (Leawood, Kan.) · 2026Article
- Survey of the Availability of Neurology Services on Hawai'i Island.Hawai'i journal of health & social welfare · 2026Article
- Article
- Rural-Urban Differences in Patient-Sharing by Clinicians Caring for Children with Medical Complexity: Network Analysis of the Pediatric Workforce in Three States.The Journal of pediatrics · 2025Article
- Increasing prevalence of cirrhosis among insured adults in the United States, 2012-2018.PloS one · 2024Article
- Geographic Variation in NAFLD Prevalence and Subspecialty Care Utilization Among Insured Adults in the United States.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Completeness of cohort-linked U.S. Medicare data: An example from the Agricultural Health Study (1999-2016).Preventive medicine reports · 2022Article
- Effects of GP characteristics on unplanned hospital admissions and patient safety. A 9-year follow-up of all Norwegian out-of-hours contacts.Family practice · 2022Article
- Physician Referrals During Prenatal Care.Maternal and child health journal · 2021Article
- Association of Follow-Up After an Emergency Department Visit for Mental Illness with Utilization Based Outcomes.Administration and policy in mental health · 2021Article
- The association of insurance plan characteristics with physician patient-sharing network structure.International journal of health economics and management · 2021Article
- Association of Insurance Status With Provision of Recommended Services During Comprehensive Postpartum Visits.JAMA network open · 2020Article
- Differences in referral patterns for rural primary care physicians from 2005 to 2016.Health services research · 2020Article
- Article
Corrections and comments
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Authors and funding
1 author.
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Abstract
objectiveTo examine differences in referral patterns in a nationally representative sample between primary care physicians (PCP) practicing in rural vs nonrural areas and changes over time. STUDY
designUsing the 2005-2016 National Ambulatory Medical Care Survey and multivariate logit regression models, I compare referral patterns of PCPs in rural vs nonrural areas. DATA COLLECTION: Multiple years of data were combined. PRINCIPAL
findingsA PCP visit was 1.9 percentage points (95% confidence interval: 0.1 pp, 3.8 pp) more likely to result in a referral in nonrural areas than rural areas, controlling for physician and patient characteristics, a 17 percent increase. This difference is driven by a widening gap in referral rates between nonrural and rural areas over time, with large differences in later periods. The regression-adjusted predicted probability of a PCP visit resulting in a referral was 71 percent higher in nonrural than rural areas in 2013-2014 and 92 percent higher in 2015-2016.
conclusionsRecognizing that the optimal PCP referral rate is unknown, referrals are less common in rural areas with a widening gap in recent years. This difference may reflect specialist availability, distance to care, or patient preferences. As changes occur to health care financing and delivery, continuing to monitor practice patterns is important to ensure patients are receiving appropriate levels of care across geographic regions.
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