Primary Care

Increasing the number of primary care physicians can reduce the rate of hospitalizations for bacterial pneumonia

Bacterial pneumonia often strikes the elderly after a bout of flu or a cold. It is also considered a preventable condition because good outpatient care can potentially thwart the need for hospitalization, and early intervention can curb complications or more severe disease. University of Texas researchers Frank C. Lemus, Ph.D., Jean L. Freeman, Ph.D., and colleagues found that hospitalizations for bacterial pneumonia from 1999 to 2000 were 3 times the national rate in the 32 Texas counties that border Mexico. Additionally, hospitalization rates for Hispanic elders (aged 65 or older) were 41 percent higher than for white elders. However, an increase of 1 primary care provider per 1,000 people reduced pneumonia-related hospitalizations by a third in these largely Hispanic communities. This finding reinforces the importance of primary care physicians in reducing hospitalizations for preventable conditions, the authors note.

The researchers found that each $1,000 increase in county median household income was associated with a 3.36 percent increase in the hospitalization rate for bacterial pneumonia. They expected that people with health insurance would be less likely to be hospitalized for bacterial pneumonia, but nearly 96 percent of Hispanic and white elders were covered by Medicare or Medicaid.

These findings suggest that placing additional primary care physicians in communities may lower the hospitalization rates for this preventable condition. This measure would, in turn, reduce public health care costs and improve elders' quality of life. This study used hospital discharge, U.S. Census, and Healthcare Cost and Utilization Project data and was funded in part by the Agency for Healthcare Research and Quality (HS16381 and HS11618).

See "Correlates of bacterial pneumonia hospitalizations in elders, Texas border," by Drs. Lemus and Freeman, Alai Tan, Ph.D., and others published online in the March 18, 2009, Journal of Immigrant and Minority Health (e-pub).

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