Primary Care Appointment Availability and Preventive Care Utilization: Evidence From an Audit Study

In Medical Care Research and Review, Brendan Saloner (Johns Hopkins University), and Penn colleagues Dan Polsky, Ari Friedman and Karin Rhodes, analyzes adult preventive care utilization and primary care appointment availability. The authors link individual-level, cross-sectional data on adult preventive care utilization from the 2011-2012 Behavioral Risk Factor Surveillance System to novel county-level measures of primary care appointment availability collected from an experimental audit study conducted in 10 states in 2012 to 2013 and other county-level health service and demographic measures. They find that in counties with more available primary care appointments, adults with private insurance used less preventive care; however, counties with more Medicaid appointment availability saw higher utilization of preventive care among Medicaid populations. The authors conclude that the relationship between primary care appointment availability and utilization of preventive care differs based on whether non-elderly adults are on private insurance or Medicaid. They suggest that policymakers look past merely increasing the supply of providers and ensure that providers are available in lower-resource areas where the newly expanded Medicaid population lives.