title: Clinical quality performance in U.S. health centers.
abstract: OBJECTIVE
  To describe current clinical quality among the nation's community health centers and to examine health center characteristics associated with performance excellence.
  
  
  METHODS
  National data from the 2009 Uniform Data System.
  
  
  METHODS
  Health centers reviewed patient records and reported aggregate data to the Uniform Data System.
  
  
  METHODS
  Six measures were examined: first-trimester prenatal care, childhood immunization completion, Pap tests, low birth weight, controlled hypertension, and controlled diabetes. The top 25 percent performing centers were compared with lower performing (bottom 75 percent) centers on these measures. Logistic regressions were utilized to assess the impact of patient, provider, and institutional characteristics on health center performance.
  
  
  RESULTS
  Clinical care and outcomes among health centers were generally comparable to national averages. For instance, 67 percent of pregnant patients received timely prenatal care (national = 68 percent), 69 percent of children achieved immunization completion (national = 67 percent), and 63 percent of hypertensive patients had blood pressure under control (national = 48 percent). Depending on the measure, centers with more uninsured patients were less likely to do well, while centers with more physicians and enabling service providers were more likely to do well.
  
  
  CONCLUSIONS
  Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients.
authors.affiliation: Department of Health Policy and Management Director, Bloomberg School of Public Health, Johns Hopkins University, Johns Hopkins Primary Care Policy Center, Baltimore, MD, USA.
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
authors.forename: Lydie A
authors.initials: LA
authors.lastname: Lebrun
authors.forename: Jinsheng
authors.initials: J
authors.lastname: Zhu
authors.forename: Arthur S
authors.initials: AS
authors.lastname: Hayashi
authors.forename: Ravi
authors.initials: R
authors.lastname: Sharma
authors.forename: Charles A
authors.initials: CA
authors.lastname: Daly
authors.forename: Alek
authors.initials: A
authors.lastname: Sripipatana
authors.forename: Quyen
authors.initials: Q
authors.lastname: Ngo-Metzger
mesh_terms: D003151:Community Health Centers / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006801:Humans; D011320:Primary Health Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration*; D012959:Socioeconomic Factors; D014481:United States