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This dataset contains measures of the number and density of health care services per United States Census Tract or ZIP Code Tabulation Area (ZCTA) from 1990 through 2022. The dataset includes four separate files for four different geographic areas (GIS shapefiles from the United States Census Bureau).

For people with serious chronic conditions, healthcare that defaults to all available treatments without considering patient preferences risks harms that may exceed benefits. Advance care planning (ACP) has the potential to align healthcare with what is important to patients and maximize quality of life. While primary care is where most people receive most of their care, engaging patients in ACP is not routine in primary care given competing demands and limited resources. Primary care clinicians, patients, and families agree that it is preferred to make plans before there is a medical crisis. The research team's goal was to make ACP routine in primary care and to "move it upstream" so that it included improving the quality of the last years of life as well as respecting wishes for end of life care.

This study included a comparative effectiveness trial of team-based versus individual clinician-focused ACP in primary care practices. The research team adapted Ariadne Labs' Serious Illness Care Program (SICP) and aimed to determine if a team approach produces better patient outcomes and explore factors influencing implementation of ACP across practices.

Seven practice-based research networks (PBRNs) in the United States and Canada randomized their primary care practices to team-based or individual clinician-focused versions of SICP. Team members and clinicians completed training, and implementation was supported through practice facilitation. Consented patient participants completed a baseline survey after initial conversations and follow-up surveys at 6 and 12 months later. Forty practices (21 team, 19 clinician) completed training and referred patients to the study. Half of the practices were rural, 80 percent were family medicine, and 33 percent were medical residency training sites. 535 healthcare staff completed training. Both arms trained primary care providers; the team arm also trained nurses, medical assistants, and other roles. 1,321 patients and care partners were referred; and 917 consented and were enrolled (455 from team practices, 462 from clinician). Data from 802 patients were included in the primary analyses. Qualitative implementation data was collected during practice facilitation and from practice interviews.

This collection includes quantitative data collected from primary care practices (DS1) and team members and clinicians (DS2) from study sites located in the United States.

The National Study of Physician Organizations and the Management of Chronic Illness (NSPO) was designed to improve understanding of evidence-based care management processes (CMPs) as they relate to physician organizations (POs), that is, independent practice associations (IPAs) and medical groups. Since the first NSPO survey of physician organizations in 2000-2001 (NSPO1, archived as ICPSR 4455), considerable investments have been made by a number of different sources, including the Robert Wood Johnson Foundation, the California Healthcare Foundation, and The Commonwealth Fund, to bring about improved care for the chronically ill. This survey, the second NSPO survey of IPAs and medical groups (NSPO2), examined the extent to which the investments in quality improvement were translated into action. NSPO2 assessed the status of CMPs and preventive services use as well as their key drivers in 2006-2007 and the extent to which these factors have changed over time. As in the first NSPO survey, NSPO2 focused on the treatment of four chronic diseases: asthma, congestive heart failure (CHF), depression, and diabetes. Topics covered by the survey include practice type, size, age, ownership, and number of locations; clinical information systems; care management and clinical practice; activities of health insurance plans in chronic illness care; performance incentives; preventative care and health promotion; and organizational culture.

This collection has two data files. The first file contains the NSPO2 survey data, while the second contains a crosswalk between the NSPO1 and NSPO2 case identification numbers which can be used to link the data of the POs that responded to both surveys. Altogether, 369 of the 1,104 POs that responded to NSPO1 also responded to NSPO2.

This study comprises the second round of the physician survey component of the Community Tracking Study (CTS) sponsored by the Robert Wood Johnson Foundation. The CTS is a national study designed to track changes in the American health care system and the effects of the changes on care delivery and on individuals. Central to the design of the CTS is its community focus. Sixty sites (51 metropolitan areas and 9 nonmetropolitan areas) were randomly selected to form the core of the CTS and to be representative of the nation as a whole. As in the first round of the physician survey (COMMUNITY TRACKING STUDY PHYSICIAN SURVEY, 1996-1997: [UNITED STATES] (ICPSR 2597)), the second round was administered to physicians in the 60 CTS sites and to a supplemental national sample of physicians. The survey instrument collected information on physician supply and specialty distribution, practice arrangements and physician ownership of practices, physician time allocation, sources of practice revenue, level and determinants of physician compensation, provision of charity care, career satisfaction, physicians' perceptions of their ability to deliver care, views on care management strategies, and various other aspects of physicians' practice of medicine. In addition, primary care physicians (PCPs) were asked to recommend courses of action in response to some vignettes of clinical presentations for which there was no prescribed method of treatment.

Dataset 3, the Site and County Crosswalk Data File, identifies the counties that constitute each CTS site.

Dataset 4, the Physician Survey Summary File, contains site-level estimates and standard errors of the estimates for selected physician characteristics, e.g., the percentage of physicians who were foreign medical school graduates, the mean age of physicians, and the mean percentage of patient care practice revenue from Medicaid.

Coverage expansion under the Affordable Care Act (ACA) has important implications for access, and the value of coverage is dependent on the ability to access care. Most information about access to care comes from household or physician surveys.

The current data collection was gathered as a part of the Primary Care Audit Study for 10 States in the United States, 2012-2013, 2014 and 2016 to assess variation in access to primary care using a methodology that was applied across different types of states (Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas) at baseline and over-time. The project was broken up into three phases: before the ACA (2012-2013), during the launch of ACA coverage provisions such as the Medicaid fee bump and ACA marketplaces (2014), and after the full ACA implementation (2016). Insurance types in the study included commercial coverage, Medicaid, uninsured, and, in 2014 and 2016, plans purchased on the ACA market place.

The audit-level file, featured in part one of the collection, includes all completed calls and provides information from multiple dimensions (appointment availability, wait times, simulated patients' demographics, cost information, etc.).

The office-level file, featured in part two of the collection, covers all eligible offices and their characteristics (e.g., size, insurance acceptability, cost information, etc.) collected from the screening phase.

Demographic variables include simulated caller number, race, gender, and age.

This study investigated the factors that influenced the career decisions of young physicians and the characteristics of their practices. The collection has five datasets: Public-Use Version of the Young Physicians Survey (Dataset 1), Socioeconomic Monitoring System Study (Dataset 2), ZIP Code Data (Dataset 3), Verbatim Responses to the Open-Ended Questions (Dataset 4), and Restricted-Use Version of the Young Physicians Survey (Dataset 5).

The Public-Use Version of the Young Physicians Survey comprises responses from the Young Physicians Survey (YPS), plus merged data from the American Medical Association (AMA) Masterfile and the Association of American Medical Colleges' Student and Applicant Information Management System (SAIMS) database. The YPS interviewed physicians below 40 years of age who recently completed graduate medical training and were in their early years of practice. These physicians were queried about their graduate medical training, perceptions of the medical profession, current practice arrangements, career decisions, family background, patient care activities, and current income and expenses. To obtain information on current practice arrangements, respondents were questioned about the practices they worked in, including who owned the practices, the number of physicians in each practice, specialties or subspecialties practiced, usual fees for selected services, percentages of revenues from HMOs, PPOs, and IPAs, and percentages of patients who were Medicare patients, had no health insurance coverage, or were poor, Black, Hispanic, severely physically disabled, or chronically mentally ill. Questions on career decisions asked respondents about factors that influenced their career choices, such as reasons for working in multiple practices, reasons for leaving past practices, and reasons for deciding in favor of or against self-employment. Information on family background elicited by the survey includes the respondent's race, marital status, and educational debt, parents' income class and education, number of children living in the respondent's home, and whether the respondent's spouse or parents were physicians. Questions on patient care activities included questions on the number of hours spent providing uncompensated health care to the poor, and the number of hours spent with patients in a variety of settings, such as the office, emergency rooms, hospital outpatient clinics, and operating rooms. Information from the AMA Masterfile and the SAIMS database includes board certification status, AMA membership, school and year of graduation, Medical College Admission Test scores, primary undergraduate institution, most recent grade point averages, place of birth, number of acceptances to United States medical schools, parents' occupations, preferred medical specialty, and preferred practice setting.

Dataset 2 comprises responses from the AMA's Socioeconomic Monitoring System (SMS), a semiannual survey of nonfederal physicians that collected data on topics similar to those in the YPS, such as practice ownership, hours spent seeing patients in various settings, income, expenses, and opinions on practice procedures. The SMS data can be used for comparative analyses of young, prime, and senior physicians.

The ZIP Code Data contain estimates for the composition of the population residing in the ZIP code areas of the YPS respondents' main practices. This includes estimates of the size of each ZIP code area population, as well as its components with respect to gender, age, race, Hispanic ethnicity, and income. Also included are estimates of the number of physicians and their composition with respect to age, sex, practice type, and specialty.

Dataset 4 contains verbatim responses to open-ended questions asked in the YPS.

The Restricted-Use Version of the Young Physicians Survey is the same as the Public-Use Version of the Young Physicians Survey, except for some variables that were restricted from general dissemination for reasons of confidentiality. The restricted-use version includes the restricted variables, but the public-use version does not.

The purpose of this survey was to obtain information on the characteristics and practice patterns of early career physicians in order to analyze trends in physicians' activities and the supply of physicians. To that end, the survey interviewed early career physicians and re-interviewed physicians who participated in the previous survey of early career physicians PRACTICE PATTERNS OF YOUNG PHYSICIANS, 1987 (ICPSR 9277). With separate samples drawn for allopathic and osteopathic physicians, the respondents were interviewed about their medical training, medical education financing, career choices and satisfaction, practice arrangements and compensation, and patient care activities. They were also questioned about medical care management in their practice(s), perceptions of their freedom to deliver care, medical malpractice claims, and the composition of their patients, such as the percent who were poor, black, Hispanic, uninsured, covered by Medicaid or Medicare, or had severe physical disabilities, chronic mental illness, or problems with substance abuse. Demographic characteristics covered by the survey include race, Hispanic origin, year of birth, marital status, number and ages of children, and parents' education.

In addition to the variables collected by survey, the allopath sample data also comprise variables obtained from the American Medical Association (AMA) and the Student and Applicant Information Management System (SAIMS) of the Association of American Medical Colleges (AAMC). The AMA variables include gender, name of medical school, board certification status, physician's specialty, and AMA membership, while the SAIMS variables include dates of application to medical school, graduation dates, Medical College Admission Test (MCAT) scores, undergraduate grade-point averages, religious preference, career preference, preferred practice setting, educational debt, scholarship information, and participation in courses/clerkships in different subject areas.

The study comprises five data files. Dataset 1 contains the public-use version of the data for the allopath sample and Dataset 2 the public-use version of the data data for the osteopath sample. Both of these files were generated by ICPSR from the original restricted-use allopath and osteopath data files provided by the principal investigator, which are stored as Datasets 3 and 4 respectively. As noted in the ICPSR Processing Note in the codebook, Dataset 5 contains 26 restricted variables which the principal investigator omitted from the original allopath data (Dataset 3) for reasons of confidentiality. ICPSR received the omitted variables in 2009, 14 years after its initial release of the data.

For this survey, respondents from three counties in the Detroit, Michigan, area were queried about their health, satisfaction with their health care, end of life decisions, policies about life and death decisions, and experiences with life and death decisions. The first set of questions asked respondents to rate their own health and to indicate whether they had seen a health care professional in the past five years as well as what type of health professional they had seen. They were also asked whether or not they trust the health care provider's judgment on medical decisions and whether they felt that a doctor or family members would follow the respondent's instructions for life sustaining procedures. The survey also explored how satisfied respondents were with the amount of time they spent with their doctor and the doctor's response to questions as well as their honesty and concern for their patient. Additional questions asked respondents how concerned HMO's are with costs and patient health and what their opinions were on how much money is spent on medical technology and care for terminally ill patients. Another set of questions sought respondent's opinions on terminating a patient's life support in a variety of different situations, including the treatment of critically ill infants. The survey also asked whether respondents or their family had ever experienced an end-of-life decision, whether they have discussed end-of-life decisions, and what types of methods they would consider. Respondents were also asked about their attitudes on the death penalty, abortion in certain situations, physician assisted suicide and the 1998 proposal to legalize physician assisted suicide. Background information includes marital status, employment, political orientation, and income.