Journal of general internal medicine
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Chronic lower respiratory disease, heart disease, and diabetes have a higher prevalence in rural areas. Previous studies raise concerns that a lower supply of physicians is associated with negative outcomes. ⋯ This study found higher PQI scores for chronic conditions than acute conditions, indicating the need for higher-quality outpatient care to prevent avoidable hospital admissions. Further, Appalachian counties had fewer other healthcare providers and many counties lacked specialist physicians, highlighting significant disparities in healthcare access in Appalachian Ohio.
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New employees generally demonstrate lower productivity than experienced colleagues in non-healthcare sectors, but there is limited evidence on how tenure affects physician productivity. ⋯ New attending physicians had lower productivity than existing employees, though their productivity improved with increasing tenure. Among new hires, internal hires had higher productivity than external hires and were faster to reach equivalent levels. These findings are important for health systems calculating the extended cost and access implications of physician turnover and replacement.