Pursuing Equity: Contact With Primary Care and Specialist Clinicians by Demo- graphics, Insurance, and Health Status

PURPOSE Long-term shifts in specialty choice and health workforce policy have raised concern about the future of primary care in the United States. The objec-tive of this study was to examine current use of primary and specialty care across the US population for policy-relevant subgroups, such as disadvantaged popula-tions and persons with chronic illness. METHODS Data from the Medical Expenditure Panel Survey from 2004 were analyzed using a probability sample patients or other participants from the noninstitutionalized US population in 2004 (N = 34,403). The main and second-ary outcome measures were the estimates of the proportion of Americans who accessed different types of primary care and specialty physicians and midlevel practitioners, as well as the fraction of ambulatory visits accounted for by the different clinician types. Data were disaggregated by income, health insurance status, race/ethnicity, rural or urban residence, and presence of 5 common chronic diseases