Federally Qualified Health Centers and Private Practice Performance on Ambulatory Care Measures

被引：83

作者：

Goldman, L. Elizabeth ^{[1
]}

Chu, Philip W. ^{[1
]}

Tran, Huong ^{[1
]}

Romano, Max J. ^{[3
]}

Stafford, Randall S. ^{[2
]}

机构：

[1] Univ Calif San Francisco, Dept Med, San Francisco, CA 94110 USA

[2] Stanford Univ, Stanford Res Prevent Ctr, Palo Alto, CA 94304 USA

[3] Johns Hopkins Univ, Dept Med, Baltimore, MD USA

来源：

AMERICAN JOURNAL OF PREVENTIVE MEDICINE | 2012年 / 43卷 / 02期

关键词：

MEDICAID PATIENTS; FOOD INSECURITY; DISPARITIES; MANAGEMENT; SERVICES; QUALITY;

D O I：

10.1016/j.amepre.2012.02.033

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background: The 2010 Affordable Care Act relies on Federally Qualified Health Centers (FQHCs) and FQHC look-alikes (look-alikes) to provide care for newly insured patients, but ties increased funding to demonstrated quality and efficiency. Purpose: To compare FQHC and look-alike physician performance with private practice primary care physicians (PCPs) on ambulatory care quality measures. Methods: The study was a cross-sectional analysis of visits in the 2006-2008 National Ambulatory Medical Care Survey. Performance of FQHCs and look-alikes on 18 quality measures was compared with private practice PCPs. Data analysis was completed in 2011. Results: Compared to private practice PCPs, FQHCs and look-alikes performed better on six measures (p<0.05); worse on diet counseling in at-risk adolescents (26% vs 36%, p=0.05); and no differently on 11 measures. Higher performance occurred in ACE inhibitors use for congestive heart failure (51% vs 37%, p = 0.004); aspirin use in coronary artery disease (CAD; 57% vs 44%, p = 0.004); beta-blocker use for CAD (59% vs 47%, p = 0.01); no use of benzodiazepines in depression (91% vs 84%, p = 0.008); blood pressure screening (90% vs 86%, p < 0.001); and screening electrocardiogram (EKG) avoidance in low-risk patients (99% vs 93%, p < 0.001). Adjusting for patient characteristics yielded similar results, except that private practice PCPs no longer performed better on any measures. Conclusions: FQHCs and look-alikes demonstrated equal or better performance than private practice PCPs on select quality measures despite serving patients who have more chronic disease and socioeconomic complexity. These findings can provide policymakers with some reassurance as to the quality of chronic disease and preventive care at Federally Qualified Health Centers and look-alikes, as they plan to use these health centers to serve 20 million newly insured individuals. (Am J Prev Med 2012; 43(2): 142-149) (C) 2012 American Journal of Preventive Medicine

引用

页码：142 / 149

页数：8

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