PROJECTING THE NEED FOR PHYSICIANS TO CARE FOR OLDER PERSONS - EFFECTS OF CHANGES IN DEMOGRAPHY, UTILIZATION PATTERNS, AND PHYSICIAN PRODUCTIVITY

Objective: To determine the influence of differing assumptions of popu lation growth, visit rates, prevalence of functional impairment, physi cian productivity, and hospitalization rates on projected need for phy sicians to provide medical care for older persons. Design: Sensitivity analysis of a manpower model. Main Results: The factors that appear t o have the most impact on projections of physician need are related to physician productivity, especially delegation to mid-level providers, and case-mix. Other factors, such as the variability of census projec tions and per capita visit rates, are likely to have less effect on ov erall physician supply needs. Conclusions: Although case mix and deleg ation to mid-level providers may both substantially affect the need fo r physician supply to care for older persons, only the latter can be d irectly affected by health policy decisions. Consideration should be g iven to increasing the supply of mid-level providers and providing inc entives for patients and physicians to receive and provide care in del ivery systems that utilize mid-level providers extensively.