Health Centers in States With Public Health Agency Support Do Not Have Better Chronic Disease Outcomes.
OBJECTIVE
To examine the quality of chronic disease care at federally qualified health centers (FQHCs) as a function of state health agency support.


METHODS
We merged data from the 2010 Association of State and Territorial Health Officials Public Health Survey, the 2011 Area Resource File, and the 2010 Uniform Data System. Using ordinary least squares regression, we modeled hypertension and diabetes control among FQHC patients as a function of state public health agency support of FQHCs, including financial support, direct collaboration, and electronic health data exchanges.


RESULTS
The rate of hypertension control is 63.4%, while the rate of diabetes control (HbA1c <7%) is 41.3%. Some two thirds of FQHCs (67.1%) are in states whose public health agencies are fully engaged in FQHC-supporting activities, and approximately one third (34.6%) are in states whose public health agencies send and receive electronic health record data with FQHCs. However, none of our measures of public health agency support of FQHCs significantly predicted FQHC-specific chronic disease outcomes.


CONCLUSIONS
We find no evidence that state public health agency support of FQHCs affects chronic disease outcomes for FQHC patients.
University of Iowa College of Public Health, Iowa City, IA, USA brad-wright@uiowa.edu.
Brad
B
Wright
University of Iowa College of Public Health, Iowa City, IA, USA.
Andrew J
AJ
Nice
D003299:Cooperative Behavior; D003920:Diabetes Mellitus / Q000628:therapy; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005380:Financing, Government / Q000706:statistics & numerical data; D066275:Health Information Exchange / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D006973:Hypertension / Q000628:therapy; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D011635:Public Health Administration / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration*; D064876:Safety-net Providers / Q000191:economics / Q000458:organization & administration*; D012959:Socioeconomic Factors; D013219:State Government; D014481:United States
chronic disease; federally qualified health center (FQHC); health center; state health agency