If these figures are similar for the San Francisco Bay Area population, then finding a new primary care physician is important for a significant number of people in our study area each year. Because this study dealt only with primary care providers in 2 counties of the San Francisco Bay Area, the results may not be generalizable to other regions.
Because our study goal was to characterize the availability of primary care physicians who were gatekeepers in open managed care plans, we obtained information on appointment availability for routine examinations. Results may have differed if we had sought appointments for an urgent health care issue. Finally, we examined access to care in an Independent Practice Association–model managed care system. These findings may not be generalizable to other types of managed care models.
Conclusions
Physician availability is necessary for access to care within managed care plans. By defining primary care physician availability not only as presence in an area, but also as willingness to accept new patients, we are able to better identify potentially unmet needs for primary care. This study demonstrates that in the San Francisco Bay area, patients may experience moderate difficulty in obtaining access to primary care because practices are “closed” to new patients. Managed care plans should consider whether provider availability limits access to medical services in a specific region.
Acknowledgments
The authors thank Annamarie Stehli Nguyen, MPH, and Debbie Jaffe for assisting in data collection; Peter Bacchetti, PhD for statistical consultation; and Karen Vranizan, MA, Alicia Fernandez, MD, and Dean Schillinger, MD, for review of a previous version of the manuscript.
Corresponding author
Jennifer Haas, MD, MSPH, Division of General Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115. E-mail: jhaas@partners.org.