Berkeley and Dorchester county residents still struggle to find a health care provider more than their counterparts in Charleston County, according to data from a community health needs assessment.
The Tri-County Health Landscape report, created by Roper St. Francis, MUSC Health and Trident United Way, found Charleston County had 780 patients for every one primary care physician last year. That ratio more than triples to 2,460 patients per primary care physician in Dorchester County and 2,900-to-1 in Berkeley County.
The location of the Lowcountry’s two largest hospital systems, MUSC and Roper St. Francis, causes many health care providers to congregate in Charleston, said Kellye McKenzie, director of health at Trident United Way.
“The bottom line is it is harder to attract primary care providers to more rural areas. Period,” McKenzie said. “You can see this played out not just in South Carolina but around the country. Berkeley and Dorchester counties are not unique to that.”
Berkeley and Dorchester counties have a higher ratio than the national rate of 1,410 patients per primary care physician and the state rate of 1,500 to one, the report said.
Residents in Berkeley and Dorchester counties often are forced to travel across county lines to get the care they need, and some don’t have their own transportation, McKenzie said.
“In some of the focus groups that we did and some of the conversations that we’ve had with community stakeholders, there are examples of individuals in Berkeley and Dorchester counties, for instance, seeking ambulatory services, seeking an ambulance, for basic preventative treatment, and that’s simply because they don’t have a way to get into Charleston from Berkeley or Dorchester counties,” she said.
When people don’t have consistent primary care providers, chances are greater that they’ll end up in an emergency room for acute, chronic conditions that could be treated cheaper and faster in a doctor’s office, said Renee Linyard, program director of Access Health Tri-County Network. The network, based at Roper St. Francis, comprises area hospitals and partners that work to improve access to care.
“For primary care, many times those clinically preventative diagnoses come out of that primary care engagement with a primary care provider,” she said.
McKenzie said the value of a primary care provider as a care coordinator is often overlooked.
“If I, as a woman, for instance, have to go to my OB/GYN and then potentially have some other kind of specialized health issue, it’s great for all of that information to be housed in one place,” she said. “Nine times out of 10, my primary care provider would be the person who is the keeper of all of that information. In addition to being able to tap into the services of a primary care provider, it’s also critical for folks to have a one-stop shop or have their care coordination in one place.”
The disparities in care aren’t unique to primary care physicians, though; similar results were reported for mental health providers and dentists.
The report found 320 patients to every one mental health provider in Charleston County, which is much lower than 798-to-1 in Dorchester County and 1,261-to-1 in Berkeley County.
For dentists, the report found 3,670 patients to every one in Berkeley County, 1,833-to-1 in Dorchester County and 987 -to-1 in Charleston County last year.
Additionally, the report found that between 17% and 19% of tri-county residents, depending on county, were uninsured in 2016, which is about the same as the South Carolina and national averages.
“Those numbers are still too high. I think there’s a long way for us to go in terms of ensuring that folks have the coverage that they need across the state and within the tri-county,” McKenzie said.
To increase the number of insured South Carolinians, Linyard said it’s imperative for organizations to continue to encourage and walk residents through the steps to enroll in Affordable Care Act plans. She said President Donald Trump’s push to repeal and replace Obamacare could have a significant negative impact on access to health care. But without knowing what kind of alternative plan will be enacted, Linyard said many are in a “wait-and-see” mode on how to respond.
The three organizations behind the report are also teaming up to launch the Healthy Tri-County Initiative on Jan. 31. The multiyear initiative will focus on crafting a regional health improvement strategy using the report’s data, McKenzie said.
Businesses, faith-based organizations, nonprofits, school districts, government agencies and health care institutions will be invited to participate.
“We can’t tackle all of the health issues facing our region on our own. It’s going to take a concerted, collaborative effort to move this work along,” she said. “We do think the launch of this health initiative that’s involving a number of key stakeholders is a step in the right direction in terms of improving our regional health outcomes.”
This story appeared in the Jan. 23, 2017, print edition of the Charleston Regional Business Journal.