title: Access to specialty care and medical services in community health centers.
abstract: Although community health centers (CHCs) provide primary health services to the medically underserved and poor, limited access to off-site specialty services may lead to poorer outcomes among underinsured CHC patients. This study evaluates access to specialty health services for patients receiving care in CHCs, using a survey of medical directors of all federally qualified CHCs in the United States in 2004. Respondents reported that uninsured patients had greater difficulty obtaining access to off-site specialty services, including referrals and diagnostic testing, than did patients with Medicaid, Medicare, or private insurance.
authors.affiliation: Health Care Policy Department, Harvard Medical School, Boston, USA.
authors.forename: Nakela L
authors.initials: NL
authors.lastname: Cook
authors.forename: LeRoi S
authors.initials: LS
authors.lastname: Hicks
authors.forename: A James
authors.initials: AJ
authors.lastname: O'Malley
authors.forename: Thomas
authors.initials: T
authors.lastname: Keegan
authors.forename: Edward
authors.initials: E
authors.lastname: Guadagnoli
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Landon
mesh_terms: D000328:Adult; D003151:Community Health Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D004470:Economics, Medical; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data; D008511:Medicine / Q000706:statistics & numerical data*; D008875:Middle Aged; D008486:Physician Executives; D011203:Poverty; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data*; D013038:Specialization; D014481:United States