Health Professional Shortage Areas (HPSA)

analyze health professional shortage areas (hpsa) with r a health professional shortage area (hpsa) is a geographic area, population group, or health care facility that has been designated by the united states government as having an insufficient supply of medical providers, based on certain provider-to-population ratios. primary care physician shortage areas are usually defined as any geography with fewer than one general practitioner for every 3,500 residents. dental and mental health shortage areas have fewer than one dentist or mental health professional per 5,000 and 30,000 residents, respectively. states and locales have some financial incentives to receive this designation: medicare bonuses, loan repayment, etc. the united states health resources and services administration (hrsa) holds the key to this data castle. to quickly understand exactly what's possible with this microdata, look at hrsa's nationwide statistics table. alright, you got me, this isn't a complex sample survey. but hey, merge it onto other survey data sets. what's that? other data sets don't have census tract- or minor civil division-level identifiers? perhaps not in their public use files, but visit the data centers and you might find the geocodes you seek. this new github repository contains three scripts: download current hpsa table.R download the zipped health professional shortage areas file directly onto your computer load the primary care physician, dental, and mental health shortage area tables into r save each file as an r data file (.rda) for fast loading later identify point-in-time geographic hpsas.R limit the primary care physician hpsa data to only records actively designated on the date specified further limit the data to only geographic a reas (and possibly certain population groups) if included: create flags for each of the major population groups extract and save county-, minor civil division-, and census tract-level records from this original file replicate hrsa nationwide statistics.R excel_round, floor, and subset as specified during conversations with the friendly folks at hrsa precisely match all five numbers in the top row of hrsa's current designation statistics table click here to view these three scripts for more detail about health professional shortage areas, visit: the shortage area homepage the hrsa data warehouse notes: depending on your goals and motivations, the cartography tools at hrsa's data n statistics pages might have all you re ally want. loading the microdata into r is for the tinkerers among us. for a mapping between minor civil divisions and other geographies, check out the missouri census data center's geocorr12. depending on what geographies you have available in the data set you're merging hpsa data to, you'll have to make some decisions about what to do when one minor civil division overlaps two or more, say, zip code tabulation areas. geocorr12 provides an `afact` column, which is just the percent of the population of the geography you're mapping from that lives in the geography you're mapping to. woo hoo. confidential to sas, spss, stata, and sudaan users: why run a three-legged race when you can sprint like an olympian? time to transition to r. :D本数据集用于分析卫生专业人员短缺区（Health Professional Shortage Area, HPSA）。卫生专业人员短缺区（以下简称HPSA）是美国政府基于特定医护人员与人口比例，认定存在医护人员供给不足的地理区域、人口群体或医疗保健机构。其中，初级护理医师短缺区通常定义为每3500名居民中全科医师不足1名的地理区域；牙科与心理健康短缺区的认定标准则分别为每5000名居民中牙医不足1名、每30000名居民中心理健康专业人员不足1名。 各州及地方行政区域若获得HPSA认定，可获得相关财政激励，如医保奖金、贷款偿还等。美国卫生资源与服务管理局（Health Resources and Services Administration, HRSA）掌控该微数据的核心资源。若需快速了解该微数据的可用范围，可查阅HRSA发布的全国统计表格。 坦率而言，本数据集并非复杂的抽样调查数据集，但可与其他调查数据集进行合并。若遇其他数据集未提供普查区（census tract）或基层民政分区（minor civil division）级别的标识符的情况：其公开使用文件中或许并无此类信息，但可通过访问数据中心获取所需的地理编码。 本GitHub新仓库包含三个R脚本： 1. `download_current_hpsa_table.R`：可直接将压缩的卫生专业人员短缺区文件下载至本地，将初级护理医师、牙科及心理健康短缺区表格导入R环境，并将各文件保存为R数据文件（.rda），以便后续快速加载。 2. `identify_point-in-time_geographic_hpsas.R`：将初级护理医师HPSA数据限定为指定日期处于有效认定状态的记录；进一步将数据筛选至仅保留地理区域（若包含特定人口群体则一并纳入），并为各主要人口群体创建标记；从原始文件中提取并保存县级、基层民政分区级及普查区级的记录。 3. `replicate_hrsa_nationwide_statistics.R`：根据与HRSA工作人员沟通确认的规则，执行Excel式取整、向下取整及数据子集筛选操作，精准匹配HRSA当前认定统计表格首行的全部五项数值。 如需查看这三个脚本的详细内容，请点击此处；欲了解更多卫生专业人员短缺区相关信息，请访问：短缺区主页、HRSA数据仓库。 备注：根据你的研究目标与需求，HRSA数据与统计页面提供的制图工具或许就能满足全部所需。将微数据导入R环境仅面向乐于动手探索的用户。 如需获取基层民政分区与其他地理区域的映射关系，请查阅密苏里州普查数据中心的Geocorr12工具。根据你需要合并HPSA数据的数据集所提供的地理层级，你可能需要处理单个基层民政分区与两个及以上（例如邮编统计区域）重叠的情况。Geocorr12提供了`afact`列，该列代表你所映射的源地理区域的人口中，迁入目标地理区域的人口占比。太棒了。 致SAS、SPSS、Stata及SUDAAN用户：与其进行繁琐的“三足赛跑”，不如像奥运选手一样全力冲刺——是时候转向R语言了。:D