A study at the Kansas University Medical Center shows that the number of Kansas counties critically underserved in primary care is declining.
The 1991 Kansas Medically Underserved Areas Report, an annual report put together by Ron Spangler, director of the Office of Institutional Research and Planning at KUMC, shows that the number of critically underserved counties dropped from 62 in 1990 to 52 in 1991. Nine counties were listed as underserved in the report.
Nearby counties considered underserved are Leavenworth and Miami. Some of the critically underserved counties in northeast Kansas are Jackson, Jefferson, Franklin, Osage, Wabaunsee and Osage.
A county is considered critically underserved in primary care which includes family practice, general practice, internal medicine and pediatrics when there are one or fewer full-time equivalent non-federal physicians per 3,000 residents. A county is classified as underserved with one or fewer full-time equivalent non-federal physicians per 2,695 residents.
SPANGLER SAID the 10-county decrease was encouraging but modest.
"It is good," Spangler said Tuesday. "The impact is modestly good. When the previous year's report came out, there were 64 areas designated as underserved or critically underserved."
Spangler explained that by the time researchers reviewed the 1990 figures broken down as 13 underserved counties and 51 critically underserved counties doctor-to-patient ratios had changed in some counties and the number of underserved and critically underserved counties had increased to 77, with 15 counties being underserved and 62 critically underserved.
So although there was a decrease from 1990, Spangler said the state is obviously still experiencing a problem in rural areas.
Spangler said "largely the same counties" show up as underserved and critically underserved in the annual studies.
"COUNTIES WITH lower populations are typically underserved. Now that's not always true," Spangler said, adding that counties that are served by enough physicians usually contain modest-sized towns.
As part of the med center's strategy to decrease the number of underserved and critically underserved counties, about 35 students enter the Kansas Medical Scholarship Program each year. Students in the program agree to practice in underserved areas and exchange one year of practice for each year of scholarship aid they received.
Spangler said the annual report he prepares is distributed to students in the scholarship program and to communities that request it.
Pointing out changes in the scholarship program, Spangler said students who entered the program before 1986 could serve in areas designated as underserved in the new report. Those counties are shown in the map accompanying this story.
Students who started in the program in or after 1986 are required to serve their obligation in cities with fewer than 12,000 residents, Spangler said.