Matching physician supply and requirements: testing policy recommendations.

Managed care has been growing and likely will increase market share. This movement will require fundamental alterations in the number and specialty distribution of physicians. Under current production, future supply does not appear well-matched with requirements. Although the adequacy of generalist supply is of concern, the oversupply of specialists is the overriding problem. Neither reducing the number of first-year residents nor increasing the generalist output alone would bring both generalist and specialist supply within requirement ranges. Combining an increase in generalist production to 50% with a reduction in first-year residents to 110% of the number of U.S. medical graduates would minimize the projected specialty surplus while maintaining generalist supply within the requirement range.

Correlates of emergency room utilization in the first year of life.

We conducted a case-control study to examine the correlates of emergency room use in the first year of life, particularly the role of parental health beliefs, among the families of inner-city children enrolled in a hospital-based primary care program. Data was collected by structured interviews and by medical record review. Emergency room users were more likely to have single mothers and to have acute, recurrent medical conditions than were non-users. Health beliefs differed between groups by maternal report of worry about the kinds of illnesses that her child acquires. Emergency room use was predicted by: maternal marital status, maternal worry and concern that illness interferes with her child's activity, acute recurrent illnesses, hospitalization. This model may be applicable to other populations in designing intervention strategies to modify emergency room utilization.