Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care

Abstract

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.

Keywords: Safety net; preventive care; utilization.