Document Type
Article
Publication Date
2026
Advisor
Jeannette Manger
Abstract
Background: Based on prior literature, limited access to primary care has been linked to higher preventable hospitalization rate. Particularly, rural communities often face physician shortages, contributing to disparities in health outcomes. Objective: To understand the relationship between primary care access and preventable hospitalization rates among medicare populations in California. Methods: The data was gathered from County Health Rankings & Roadmaps for 56 California counties, excluding Sierra and Alpine. This study used unpaired t-tests to determine the difference in the PCP ratio and preventable hospitalization rate between rural and urban counties in California in 2025. A paired t-test was performed to assess the change in the PCP ratio in California from 2022 to 2025. A Spearman correlation measured the correlation between PCP ratio and preventable hospitalization rate in California in 2025. Results: The ratio of people to primary care physicians was significantly higher in California rural counties (2461.53:1) as compared to urban ones (1594.86:1) in 2025 while the preventable hospitalization rate was not significantly different between rural (2110.47) and urban (2299.62) counties that same year. From 2022 (1773.64:1) to 2025 (1888.91:1), there was no significant change in the PCP ratio in California. In 2025, there was a moderate but significant correlation (r = .552, p < .001) between the ratio of people to primary care physicians and preventable hospitalization rate in California, where the ratio of people to primary care physicians increased with the preventable hospitalization rate. Finally, A linear regression model measured how the ratio of people to primary care physicians predicts the variance in preventable hospitalization rate in California counties in 2025. This showed that the PCP ratio explained 28% of preventable hospitalizations in California (F(1,54)=22.01, p< .001).
Repository Citation
Shenouda, M., & Shashi, S. (2026). Primary Care Access and Preventable Hospitalizations: A Multi-Variable Analysis of Medicare Populations in California (2022–2025). Wright State University. Dayton, Ohio.
