title: Comparative effectiveness of health centers as regular source of care: application of sentinel ACSC events as performance measures.
abstract: A 4-state (Alabama, California, Georgia, Pennsylvania) retrospective analysis of claims data from 1.6 million Medicaid beneficiaries to assess the performance of community health centers compared with other Medicaid providers (office-based and hospital-based practices) served as a regular source of care to Medicaid beneficiaries, each with at least one diagnosed ambulatory care-sensitive condition (ACSC). The health centers compared with the other Medicaid providers experienced one third fewer sentinel ACS events: 5.7 and 8.2 ACS admissions and 26.1 and 37.7 ACS emergency visits, respectively, per 100 persons. Controlling for case mix and other factors, the logistic regression results for sentinel events indicated that Medicaid beneficiaries who relied on health centers for primary care were significantly less likely to experience an ACS admission (OR = 0.89, P < .0001) or an ACS emergency visit (OR = 0.81, P < .0001) than the Medicaid beneficiaries who relied on other Medicaid providers. Sentinel ACS events can serve as efficient measures for assessing provider performance and comparing effectiveness of regular sources for primary care.
authors.affiliation: MDS Associates, Washington, DC 20008, USA. MDSWDC@aol.com
authors.forename: Marilyn
authors.initials: M
authors.lastname: Falik
authors.forename: Jack
authors.initials: J
authors.lastname: Needleman
authors.forename: Robert
authors.initials: R
authors.lastname: Herbert
authors.forename: Barbara
authors.initials: B
authors.lastname: Wells
authors.forename: Robert
authors.initials: R
authors.lastname: Politzer
authors.forename: M Beth
authors.initials: MB
authors.lastname: Benedict
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D012189:Retrospective Studies; D018571:Sentinel Surveillance; D014481:United States