Health Care Utilization and Receipt of Preventive Care for Patients Seen at Federally Funded Health Centers Compared to Other Sites of Primary Care
Health Care Utilization and Receipt of Preventive Care for Patients Seen at Federally Funded Health Centers Compared to Other Sites of Primary Care
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DOI：
10.1111/1475-6773.12178
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发表时间：
2014-10-01
影响因子：
3.4
通讯作者：
Huang, Elbert S.
中科院分区：
文献类型：
--
作者：
Laiteerapong, Neda;Kirby, James;Huang, Elbert S.
目标。比较联邦330医疗中心（hc）患者与其他机构患者的使用率和预防性护理接收情况。数据源。来自医疗支出小组调查（2004-2008年）的具有全国代表性的成年人样本。研究设计。HC患者被定义为在第一个小组年，在HC的门诊访问量>= 50%的患者。结果包括第二个小组年的使用率和预防性护理收据。我们使用负二项回归和逻辑回归模型，并使用倾向评分调整来分析HC和非HC患者之间的混淆差异。主要的发现。与非HC患者相比，HC患者就诊次数（调整发病率比[aIRR]， 0.63）和住院次数（aIRR, 0.43）较少（p < 0.001）。HC患者接受乳腺癌筛查的可能性高于非HC患者（校正优势比[aOR] 2.78, p < 0.01）。在亚组分析中，与非HC患者相比，未投保的HC患者门诊和急诊室就诊次数较少，更有可能接受饮食建议和乳腺癌筛查。卫生中心通过为社会和医学上处于不利地位的患者提供护理，从而降低利用率，维持或改善预防保健，从而增加卫生保健系统的价值。
Objective. To compare utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings.Data Sources. A nationally representative sample of adults from the Medical Expenditure Panel Survey (2004-2008).Study Design. 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.Principal Findings. 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.