Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.
OBJECTIVE
To compare utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings.


METHODS
A nationally representative sample of adults from the Medical Expenditure Panel Survey (2004-2008).


METHODS
HC patients were defined as those with ≥50 percent of outpatient visits at HCs in the first panel year. Outcomes included utilization and preventive care receipt from the second panel year. We used negative binomial and logistic regression models with propensity score adjustment for confounding differences between HC and non-HC patients.


RESULTS
Compared to non-HC patients, HC patients had fewer office visits (adjusted incidence rate ratio [aIRR], 0.63) and hospitalizations (aIRR, 0.43) (both p < .001). HC patients were more likely to receive breast cancer screening than non-HC patients (adjusted odds ratio [aOR] 2.78, p < .01). In subgroup analyses, uninsured HC patients had fewer outpatient and emergency room visits and were more likely to receive dietary advice and breast cancer screening compared to non-HC patients.


CONCLUSIONS
Health centers add value to the health care system by providing socially and medically disadvantaged patients with care that results in lower utilization and maintained or improved preventive care.
University of Chicago, 5841 S. Maryland Ave., MC 2007, Chicago, IL, 60637.
Neda
N
Laiteerapong
James
J
Kirby
Yue
Y
Gao
Tzy-Chyi
TC
Yu
Ravi
R
Sharma
Robert
R
Nocon
Sang Mee
SM
Lee
Marshall H
MH
Chin
Aviva G
AG
Nathan
Quyen
Q
Ngo-Metzger
Elbert S
ES
Huang
D000328:Adult; D000368:Aged; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D035082:Federal Government; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D016017:Odds Ratio; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
Safety net; preventive care; utilization