Health Professions Education

Role of Title VII/VIII Programs in Improving Access to Care Is Unclear Gao ID: HEHS-94-164 July 8, 1994

During the past decade, the supply of nearly all health professionals has increased faster than has the population. For most health professions, however, data are unavailable to show whether this increased supply has translated into more access to care in rural and underserved areas. For the two professions with the most data available--primary care physicians and general dentists--supply has increased in many rural areas but not in those urban and rural areas with the greatest shortages. GAO's findings are similar for minority recruitment: Although the number of minorities in the health professions is increasing, data are inconclusive about whether further increases will improve access to health care for underserved populations. Although nearly $2 billion has been provided to 30 Title VII and VIII programs during the last 10 years, evaluations have not shown that these programs have had a significant effect on changes in the supply, distribution, and minority representation of health professionals.

GAO found that: (1) the supply of health professions has increased faster than the population, but data are not available to determine whether rural and underserved areas have greater access to health care; (2) the supply of primary care providers and general dentists has increased in some areas but not in the most underserved urban and rural areas; (3) minority representation in health professions has increased faster than the professions' total increase; (4) program evaluations have not shown that the programs have had a significant effect on the changes in supply, distribution, and minority representation; (5) the effect of the programs on health professions is difficult to measure because the programs have additional objectives, there are no common outcome goals or measurements, and evaluators are unable to separate the effects of other funding sources; and (6) Congress has recently targeted more program funding specifically for primary care and underserved areas, but this is not likely to have much impact.

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