Primary Care Capacity Shortage and the Potential Impact of Hospital Closures

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Facing budget constraints and a new Governor in 2006, New York State was (and continues to be) engaged in a complex and challening policy discussion about the size and shape of its health care system. This is particularly meaningful even now, as resources are shrinking or changing and what resources will be available to support the restructuring of that system.

A primary catalyst of the 2006 effort was the formation of the Commission on Health Care Facilities in the 21st Century. The Commission’s final report, due at the end of 2006, included specific recommendations on hospital and long-term care facility restructuring and closures. These recommendations as presented in 2006, will continue to have significant implications for New York City.

A major gap in the Commission’s charge is primary care, which represents the majority of community based health services before and after hospitalization. To that end, PCDC and the New York City Health and Hospitals Corporation (HHC) conducted an analysis of primary care physician availability and population vulnerability in New York City. The purpose of this analysis was to:

• Assess primary care physician capacity available to New York City’s residents, particularly low-income New Yorkers;
• Determine how primary care physician availability may be affected by hospital restructuring/closures; and
• Identify considerations that policymakers should take into account to maintain access to care and to ensure that the health of low-income or vulnerable New Yorkers is not compromised when making hospital restructuring/closure decisions.