Most advanced nations, such as those belonging to the Organisation for Economic Co-operation and Development, recognize and fully finance the central role of primary care in their health care delivery systems.1 They spend about 20% of their total health care dollars on primary care, support a 1:1 ratio of specialists to primary care physicians, and rank among the highest in population health status while keeping per capita health care costs relatively modest.1-3 This is not the case in the United States, where primary care accounts for only 7% of total health care spending and specialists outnumber primary care doctors by a ratio of 2 to 3:1,3 resulting in the world’s highest per capita health care costs and subpar population health status.2 The underfunding of US primary care has been suggested as one of the principal causes of the poor performance by our health care delivery system.4 In a landmark international study, Starfield and colleagues5 found that where primary care is available, per capita costs are lower, health status is better, and health disparities are fewer.
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Goroll AH. Does Primary Care Add Sufficient Value to Deserve Better Funding? JAMA Intern Med. Published online January 28, 2019. doi:10.1001/jamainternmed.2018.6707
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