It’s become evident that more health care does not often lead to better health: Shannon Brownlee’s seminal book, Overtreated, uncovered the negative relationship between more health care and worse outcomes.

However, when it comes to accessing primary care, more may be a good thing. In Extended Office Hours and Health Care Expenditures: A National Study, published this week in the Annals of Family Medicine, researchers found that offering longer office hours, into evenings and weekends, leads to lower total health care expenditures for patients than practices without extended hours. Extended hours are also associated with lower prescription drug and office visit related testing costs.

Furthermore, lower costs for these patients did not result in higher mortality.

The researchers, Dr. Anthony Jerant of UCLA-Davis, et. al., say that clinicians working in extended-office hours practices may be more cost-conscious, prescribing more generic meds and fewer tests, taking note that patient-centered care is associated with decreased health care utilization (see Bertakis et. al., in Journal of the American Board of Family Medicine, 2011;224(3):229-239). In addition, patients with access to extended-hours care seek emergency room use less often, although Jerant’s team points out that in year 2 of the study, lower ER costs did not significantly impact the overall cost results.

Health Populi’s Hot Points: A strong, comprehensive and accessible primary health care “backbone” underpins the highest-performing health systems around the world, found in Denmark, the United Kingdom, and New Zealand, among many other countries that value primary care. We can quantify the “valuation” of primary care by examining what proportion of health care resources (dollars, labor) are allocated to primary care in an overall health system.

Compared to these other systems, in the U.S., primary care is under-funded and under-resource allocated in terms of the laboor force. Primary care providers will also tell you they’re “under-appreciated.

Evidence continues to grow arguing for a stronger primary care infrastructure in the U.S. This research furthers the argument for greater access to primary care for U.S. health citizens as part of a multi-pronged strategy to lower the cost curve in American health care…

 

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