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Research ArticleOriginal Research

Primary Care, Behavioral Health, Provider Colocation, and Rurality

Benjamin F. Miller, Stephen Petterson, Shandra M. Brown Levey, Jessica C. Payne-Murphy, Miranda Moore and Andrew Bazemore
The Journal of the American Board of Family Medicine May 2014, 27 (3) 367-374; DOI: https://doi.org/10.3122/jabfm.2014.03.130260
Benjamin F. Miller
From the Department of Family Medicine, University of Colorado Denver School of Medicine, Aurora (BFM, SMBL, JCP-M); and The Robert Graham Center, Washington, DC (SP, MM, AB).
PsyD
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Stephen Petterson
From the Department of Family Medicine, University of Colorado Denver School of Medicine, Aurora (BFM, SMBL, JCP-M); and The Robert Graham Center, Washington, DC (SP, MM, AB).
PhD
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Shandra M. Brown Levey
From the Department of Family Medicine, University of Colorado Denver School of Medicine, Aurora (BFM, SMBL, JCP-M); and The Robert Graham Center, Washington, DC (SP, MM, AB).
PhD
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Jessica C. Payne-Murphy
From the Department of Family Medicine, University of Colorado Denver School of Medicine, Aurora (BFM, SMBL, JCP-M); and The Robert Graham Center, Washington, DC (SP, MM, AB).
MA
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Miranda Moore
From the Department of Family Medicine, University of Colorado Denver School of Medicine, Aurora (BFM, SMBL, JCP-M); and The Robert Graham Center, Washington, DC (SP, MM, AB).
PhD
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Andrew Bazemore
From the Department of Family Medicine, University of Colorado Denver School of Medicine, Aurora (BFM, SMBL, JCP-M); and The Robert Graham Center, Washington, DC (SP, MM, AB).
MD, MPH
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    Figure 1.

    Distribution of primary care physicians (PCPs) at location by level of rurality.

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    Figure 2.

    Percentage of primary care physicians collocated with behavioral health providers by level of rurality and match precision.

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    Figure 3.

    Association between colocation and primary care physicians (PCPs) at location.

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    Table 1. Summary of Logistic Regression Analysis Examining Joint Impact of Size and Rurality on Colocation of Primary Care Physicians with Behavioral Health Providers
    Size and LocationRurality OnlyRurality and SizeRurality-Size Interaction
    UrbanReferenceReferenceReference
    Large rural0.552 (0.533–0.571)*0.758 (0.730–0.787)*0.921 (0.843–1.006)
    Small rural0.430 (0.410–0.452)*0.790 (0.750–0.832)*0.589 (0.515–0.672)*
    Isolated rural0.439 (0.400–0.482)*1.063 (0.961–1.174)0.807 (0.652–0.999)†
    Frontier0.537 (0.489–0.590)*1.289 (1.166–1.425)*1.118 (0.899–1.391)
    ln(size)2.676 (2.650–2.703)*2.678 (2.650–2.706)*
    Large rural*ln(size)0.907 (0.871–0.944)*
    Small rural*ln(size)1.185 (1.105–1.269)*
    Isolated rural*ln(size)1.214 (1.066–1.381)*
    Frontier rural*ln(size)1.106 (0.966–1.265)
    • Data are odds ratios (95% confidence intervals). Data are from the National Plan and Provider Enumeration System 2010 and the American Medical Association Masterfile 2010. The analysis is based on 207,955 primary care physicians in direct patient care. Ln(size) is the natural log of the number of primary care physicians located at the same location (street address). Colocation of primary care physicians and behavioral health providers also is based on the same, more precise location. The outcome variable for the three models is colocation of primary care physician with behavioral health providers.

    • ↵* Significant at 1%.

    • ↵† Significant at 5%.

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The Journal of the American Board of Family     Medicine: 27 (3)
The Journal of the American Board of Family Medicine
Vol. 27, Issue 3
May-June 2014
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Primary Care, Behavioral Health, Provider Colocation, and Rurality
Benjamin F. Miller, Stephen Petterson, Shandra M. Brown Levey, Jessica C. Payne-Murphy, Miranda Moore, Andrew Bazemore
The Journal of the American Board of Family Medicine May 2014, 27 (3) 367-374; DOI: 10.3122/jabfm.2014.03.130260

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Primary Care, Behavioral Health, Provider Colocation, and Rurality
Benjamin F. Miller, Stephen Petterson, Shandra M. Brown Levey, Jessica C. Payne-Murphy, Miranda Moore, Andrew Bazemore
The Journal of the American Board of Family Medicine May 2014, 27 (3) 367-374; DOI: 10.3122/jabfm.2014.03.130260
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