Equal or Better Quality Care Delivered in Public Health Centers

Patients, particularly those without health insurance, getting care at federally funded health centers have fewer office visits and hospitalizations, a new study reveals.

Patients, particularly those without health insurance, getting care at federally funded health centers have fewer office visits and hospitalizations, a new study by Health Services Research reports. These patients are found to receive similar or a better quality of preventive care when compared to similar patients of non-health center primary care providers.

"These findings suggest that federally funded health centers could be a more efficient system of primary care especially for the uninsured," said Neda Laiteerapong, M.D., the study's lead author and assistant professor of medicine at University of Chicago. "The fact that patients in our study had fewer office visits and received similar or better quality of care could suggest that these centers do more preventive care per visit."

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Federally funded health centers, located in communities defined as Medically Underserved Areas, provide health care for millions of people who have few health care options, are underinsured or live in isolated situations. In 2012, health centers served about 21.1 million patients.

For the study, researchers reviewed data from five panels of the two-year Medical Expenditure Panel Survey between 2004 and 2008. They analyzed data from a representative sample of adult patients who had visited federally-funded health centers over a two year period of time, and then compared outcomes of visits to non-health center primary care patients.

Compared to non-health center patients, health center patients were younger (42.3 vs. 48.3 years), disproportionately minority race/ethnicity (67 percent vs. 27 percent) and more likely to be Spanish speaking (28 percent vs 5 percent). Fewer health center patients had insurance than non-health center patients.

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In addition to fewer office visits and fewer hospitalizations, health center patients were also more likely to receive dietary advice and breast cancer screening due to incentives from publicly funded programs like the National Breast and Cervical Cancer Early Detection Program. Laiteerapong said, "These programs raise providers' awareness of the importance and availability of screening and are more apt to refer for screening than providers at other sites."

Georges C. Benjamin, M.D., executive director of the American Public Health Association (APHA), Washington D.C., said, "This study is important and will add to the literature because it verifies that if you have a coordinated care model, you can have better outcomes most of the time-this is a good example of where health reform is going."

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Benjamin pointed out there are a lot of mom and pop' clinics in practice so wrap-around services-those that provide strong links to behavioral health services and programs-make a case for why good case management is critically important for health care today. "We know only 10 percent of primary care wellness is about going to the doctor's office," he said. "It's the behavioral things that matter and federally-funded clinics understand that very well."

Benjamin added, "This study adds credence to the decision to put money into federally-funded health care clinics. These programs are very important because they act as a safety net in our society."

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Health Services Research is the official journal of the Academy Health and is published by John Wiley & Sons, Inc. on behalf of the Health Research and Educational Trust. For information, contact Jennifer Shaw, HSR Business Manager at (312) 422 2646 or [email protected]. HSR is available online at onlinelibrary.wiley.com

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