Dataset Information

Changes in primary care access at community health centers between 2012/2013 and 2016.

ABSTRACT:

Objective

To compare access at community health centers (CHCs) vs private offices (non-CHCs) under the Affordable Care Act.

Data source

Ten state primary care audit conducted in 2012/2013 and 2016.

Study design

CHCs and non-CHCs were called. We calculated difference in differences comparing CHCs vs non-CHCs by caller insurance type.

Principal findings

In both rounds, Medicaid and uninsured callers had higher appointment rates at CHC than non-CHCs. CHC appointment rates significantly increased between 2012/2013 and 2016 for both employer-sponsored and Medicaid callers, with no significant wait time changes. Appointment rates increased (13.5% points, P < 0.001) and wait times decreased (-5.7 days, P = 0.017) at CHCs relative to non-CHCs for employer-sponsored insurance.

Conclusion

Appointment availability at CHCs improved after ACA implementation, without increased wait times.

SUBMITTER: Saloner B

PROVIDER: S-EPMC6338301 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Changes in primary care access at community health centers between 2012/2013 and 2016.

Saloner Brendan B Wilk Adam S AS Wissoker Douglas D Candon Molly M Hempstead Katherine K Rhodes Karin V KV Polsky Daniel E DE Kenney Genevieve M GM

Health services research 20181105 1

<h4>Objective</h4>To compare access at community health centers (CHCs) vs private offices (non-CHCs) under the Affordable Care Act.<h4>Data source</h4>Ten state primary care audit conducted in 2012/2013 and 2016.<h4>Study design</h4>CHCs and non-CHCs were called. We calculated difference in differences comparing CHCs vs non-CHCs by caller insurance type.<h4>Principal findings</h4>In both rounds, Medicaid and uninsured callers had higher appointment rates at CHC than non-CHCs. CHC appointment rat ...[more]

PMID: 30397918

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Project description:ImportanceThe quality of routine care for children is rarely assessed, and then usually in single settings or for single clinical conditions.ObjectiveTo estimate the quality of health care for children in Australia in inpatient and ambulatory health care settings.Design, setting, and participantsMultistage stratified sample with medical record review to assess adherence with quality indicators extracted from clinical practice guidelines for 17 common, high-burden clinical conditions (noncommunicable [n = 5], mental health [n = 4], acute infection [n = 7], and injury [n = 1]), such as asthma, attention-deficit/hyperactivity disorder, tonsillitis, and head injury. For these 17 conditions, 479 quality indicators were identified, with the number varying by condition, ranging from 9 for eczema to 54 for head injury. Four hundred medical records were targeted for sampling for each of 15 conditions while 267 records were targeted for anxiety and 133 for depression. Within each selected medical record, all visits for the 17 targeted conditions were identified, and separate quality assessments made for each. Care was evaluated for 6689 children 15 years of age and younger who had 15 240 visits to emergency departments, for inpatient admissions, or to pediatricians and general practitioners in selected urban and rural locations in 3 Australian states. These visits generated 160 202 quality indicator assessments.ExposuresQuality indicators were identified through a systematic search of local and international guidelines. Individual indicators were extracted from guidelines and assessed using a 2-stage Delphi process.Main outcomes and measuresQuality of care for each clinical condition and overall.ResultsOf 6689 children with surveyed medical records, 53.6% were aged 0 to 4 years and 55.5% were male. Adherence to quality of care indicators was estimated at 59.8% (95% CI, 57.5%-62.0%; n = 160 202) across the 17 conditions, ranging from a high of 88.8% (95% CI, 83.0%-93.1%; n = 2638) for autism to a low of 43.5% (95% CI, 36.8%-50.4%; n = 2354) for tonsillitis. The mean adherence by condition category was estimated as 60.5% (95% CI, 57.2%-63.8%; n = 41 265) for noncommunicable conditions (range, 52.8%-75.8%); 82.4% (95% CI, 79.0%-85.5%; n = 14 622) for mental health conditions (range, 71.5%-88.8%); 56.3% (95% CI, 53.2%-59.4%; n = 94 037) for acute infections (range, 43.5%-69.8%); and 78.3% (95% CI, 75.1%-81.2%; n = 10 278) for injury.Conclusions and relevanceAmong a sample of children receiving care in Australia in 2012-2013, the overall prevalence of adherence to quality of care indicators for important conditions was not high. For many of these conditions, the quality of care may be inadequate.

Dataset Information

Changes in primary care access at community health centers between 2012/2013 and 2016.

Objective

Data source

Study design

Principal findings

Conclusion

Publications

Changes in primary care access at community health centers between 2012/2013 and 2016.

Similar Datasets

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