Primary Care Shortage for Poor

HHC President Al Aviles and Ronda Kotelchuck, Executive Director of the Primary Care Development Corporation

A report by the Health and Hospitals Corporation and the Primary Care Development Corporation (PCDC) found that New York City has a shortage of primary care physicians serving low-income residents and warned that the gap may widen if hospitals are closed, as state officials are now considering.

The report found 32 percent of doctors serving the poor are based in hospitals, making access to primary care for low-income New Yorkers highly vulnerable to hospital closings. The analysis also found that unnecessary emergency room use and avoidable hospitalizations are particularly high in low income communities and that the city’s outpatient health services are significantly underdeveloped compared to inpatient care.

"Primary care services are essential to keeping communities healthy. Early detection and treatment of heart disease, cancer, HIV/AIDS and other serious health conditions not only extends and saves lives, it saves money by reducing the need for acute care and emergency services,” said HHC President Alan D. Aviles.

HHC and PCDC used the findings of the report to urge the state commission charged with hospital restructuring to develop a comprehensive primary care strategy in addition to any proposed hospital closure or downsizing. State officials were also urged to reform the reimbursement system which currently underpays for primary care and at a minimum, preserve or replace existing primary care capacity if hospital downsizing or closures take place.

The state Commission on Health Care Facilities in the 21st Century is currently evaluating the size and shape of the health care system and by the end of this year will issue a report with recommendations on how the health care system should be reorganized. The State will be using $1.5 billion in federal funds over five years to support restructuring of the hospital industry.

“With the vast resources now marshaled to restructure the health care system, the State must seize this opportunity to create a comprehensive primary care strategy,” said Ronda Kotelchuck, PCDC’s Executive Director.

The HHC/PCDC report on primary care capacity in NYC is available on HHC's web site.