• Candice Chen, Nicholas Chong, Qian Luo, and Jeongyoung Park.
• Fitzhugh Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC.
• Fam Med. 2021 Sep 1; 53 (8): 689-696.

Background And ObjectivesCommunity-based residency programs are an important strategy to address rural and underserved primary care shortages, however, health centers report both benefits and challenges to training. This study aims to understand the impact of new Teaching Health Center (THC) residency programs on health center staffing, patient service, quality of care, and provider productivity.MethodsUsing the Uniform Data System, we used inverse propensity score weighting to create a balanced sample of new THC and non-THC health centers in 2010. Using 2018 data, we applied propensity score weighted regressions to examine changes in staffing, service, quality of care, and productivity in THC versus non-THC health centers.ResultsIn 2018, health centers with new THC programs were associated with increased physician (16.40, P<.01) staffing, yet decreased physician visits per full-time equivalent (-425.3, P<.01) relative to non-THC centers. New THC centers had increased delivery visits (231.0, P<.05), and had a greater rate of early entry into prenatal care (4.90%, P<.01).ConclusionsNew residency programs are associated with increased provider recruitment, expanded patient service, and some improved health outcomes, but also with potential decreased provider productivity in health centers.

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