Selected Primary Care Access and Quality Measures

Terms and Conditions of Data Use: please read before downloading data.

Please note that the rates available on this page are also available in the Dartmouth Atlas dataverse with a persistent identifier (DOI), together with additional documentation and links to related publications. We strongly recommend that individuals who intend to use these rates for research download the rates from dataverse and use the dataverse DOI in any citations.

Data include measures of primary care utilization, quality of care for diabetes, mammography, leg amputation and preventable hospitalizations. More information can be found in Regional and Racial Variation in Primary Care and the Quality of Care among Medicare Beneficiaries (2010).

Data Dictionary (.xlsx) (includes Notes About Measures; see below)

• Longitudinal
• By Year

Regarding the measure “Percent of Medicare Enrollees Having Annual Ambulatory Visit to a Primary Care Clinician” – Sudden declines in rates of primary care visits were observed in several regions—for example, Portland, Maine and Elyria, Ohio—between 2015 and 2016. We investigated the causes of these declines, ruling out several candidates (e.g., shifts in the population covered under fee-for-service Medicare) but could not determine a definitive cause. The most likely explanation is the growth of primary care alternative payment models, where visits are bundled and thus not necessarily reported in the fee-for-service claims data.

Regarding the measure “diabetic screening measures” – We noted large changes in rates of secondary screening for diabetics for a few regions between 2017 and 2018, including substantial decreases in hemoglobin A1c testing in several HRRs in Montana and North Dakota. We could not establish a conclusive explanation for these changes, especially in smaller rural areas; caution should be used in interpreting longitudinal data for these screening measures.