One of the most pervasive aspects of the American health scene has been the maldistribution of health personnel in rural and urban areas. Notwithstanding much effort at the federal and state level, shortages of physicians and other health professionals persist both in rural and urban areas, especially the remote rural locations and the inner-city urban ones. The current paradox is that despite substantial increases in their numbers of physicians, many rural and urban areas remain underserved. Federal health personnel programs such as the National Health Service Corps (NHSC) are critical tools among relevant federal programs designed to address the geographic maldistribution of health personnel and other health-related resources. But not every community or organizational entity that would like to use these programs has a significant shortage of health personnel. Eligibility for federal health personnel programs such as the NHSC is triggered by designation of an area as a Health Professional Shortage Area (HPSA), and eligibility for other federal interventions requires designation as a Medically Underserved Area (MUA). In fact, eligibility for a considerable number of federal and state programs is based on whether an area or population meets the HPSA and MUA/P criteria. The main activity of this project was to use detailed Washington State data for the 124 generalist Health Service Areas (HSAs) to evaluate alternative variations of the HPSA criteria. Evaluations included examining how sensitive the designations were to changes in the designation methodology and in changes to the method of counting primary care providers. Project results provide comparative information on the numbers of HSAs receiving shortage designations using the various combinations of designation and provider counting methodologies. The project was funded by HRSA’s Office of Rural Health Policy (ORHP) and Bureau of Primary Health Care (BPHC).
|Andrilla CHA, Hart LG||Evaluation of alternative Health Professional Shortage Area (HPSA) definitions in Washington State||PUBLICATION||08-21-2006|