Assessing primary care content: four conditions common in community health center practice.
Under managed care, community health center (CHC) care patterns will be increasingly subject to outside scrutiny. This article discusses results of medical records reviews assessing quality of care at CHCs for acute otitis media, diabetes, asthma, and hypertension. As a group, these safety net providers meet or exceed prevailing practice across other health care settings; however, there is substantial variation among sites. Regression analyses indicate that the individual CHC used by a patient is the most consistent determinant of whether a patient receives recommended care. Drawing on these results, the article explores approaches for improving care and discusses the implications for performance measurement among CHCs and other safety net providers.
Ulmer
C
C
Lovelace Clinic Foundation, Albuquerque, New Mexico, USA.
Lewis-Idema
D
D
Von Worley
A
A
Rodgers
J
J
Berger
L R
LR
Darling
E J
EJ
Lefkowitz
B
B
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000628:therapy; D002648:Child; D003151:Community Health Centers / Q000592:standards*; D003920:Diabetes Mellitus / Q000628:therapy; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000628:therapy; D008329:Managed Care Programs / Q000592:standards; D008485:Medical Audit; D008875:Middle Aged; D010033:Otitis Media / Q000628:therapy; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care; D014481:United States