title: Federally Qualified Health Center Use Among Dual Eligibles: Rates Of Hospitalizations And Emergency Department Visits.
abstract: People who are eligible for both Medicare and Medicaid, known as "dual eligibles," disproportionately are members of racial or ethnic minority groups. They face barriers accessing primary care, which in turn increase the risk of potentially preventable hospitalizations and emergency department (ED) visits for ambulatory care-sensitive conditions. Federally qualified health centers provide services known to address barriers to primary care. We analyzed 2008-10 Medicare data for elderly and nonelderly disabled dual eligibles residing in Primary Care Service Areas with nearby federally qualified health centers. Among our findings: There were fewer hospitalizations for ambulatory care-sensitive conditions among blacks and Hispanics who used these health centers than among their counterparts who did not use them (16 percent and 13 percent fewer, respectively). Use of the health centers was also associated with 3 percent and 12 percent fewer hospitalizations for ambulatory care-sensitive conditions among nonelderly disabled blacks and Hispanics, respectively. These findings suggest that federally qualified health centers can reduce disparities in preventable hospitalizations for some dual eligibles. However, further efforts are needed to reduce preventable ED visits among dual eligibles receiving care in the health centers.
authors.affiliation: Brad Wright (brad-wright@uiowa.edu) is an assistant professor in the Department of Health Management and Policy and the Public Policy Center at the University of Iowa, in Iowa City.
authors.forename: Brad
authors.initials: B
authors.lastname: Wright
authors.affiliation: Andrew J. Potter is a PhD student in the Department of Health Management and Policy, University of Iowa.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Potter
authors.affiliation: Amal Trivedi is an associate professor in the Department of Health Services, Policy, and Practice at the School of Public Health, Brown University, and an investigator in the Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, both in Providence, Rhode Island.
authors.forename: Amal
authors.initials: A
authors.lastname: Trivedi
mesh_terms: D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D003151:Community Health Centers / Q000706:statistics & numerical data*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004608:Eligibility Determination; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D014481:United States; D001741:Black or African American
keywords: Access To Care; Disparities; Hospitals; Safety-Net Systems; Special Populations