Younger Dual-Eligibles Who Use Federally Qualified Health Centers Have More Preventable Emergency Department Visits, but Some Have Fewer Hospitalizations

Andrew J Potter; Amal N Trivedi; Brad Wright

doi:10.1177/2150131916657081

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Younger Dual-Eligibles Who Use Federally Qualified Health Centers Have More Preventable Emergency Department Visits, but Some Have Fewer Hospitalizations

Journal article

Open access

Peer reviewed

Younger Dual-Eligibles Who Use Federally Qualified Health Centers Have More Preventable Emergency Department Visits, but Some Have Fewer Hospitalizations

Andrew J Potter, Amal N Trivedi and Brad Wright

Journal of primary care & community health, Vol.8(1), pp.3-8

07/01/2016

DOI: 10.1177/2150131916657081

PMCID: PMC5300961

PMID: 27371525

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300961View

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Abstract

To determine whether younger dual-eligibles receiving care at federally qualified health centers (FQHCs) have lower rates of ambulatory care sensitive (ACS) hospitalization and emergency department (ED) visits. We used the 100% Medicare Part A and Part B institutional claims from 2007 to 2010 for dual-eligibles younger than 65 years, enrolled in traditional fee-for-service Medicare, who received care at an FQHC or lived in a primary care service area with an FQHC. Our cross-sectional analysis used negative binomial regressions to model ACS hospitalizations and ED visits as a function of prior year FQHC use. The model adjusted for beneficiary age, gender, race, and chronic diseases, as well as county fixed effects, time trends, and race-FQHC use interactions. FQHC use is associated with a decrease in ACS hospitalization rates for whites (2.8 per 1000 persons), but an increase among blacks (2.5 per 1000 persons). FQHC use is also associated with an increase in ACS ED visits, from 27 to 33 more visits per 1000 persons per year, depending on patient race. ACS hospital use is higher for FQHC users than nonusers, but white FQHC users have fewer ACS hospitalizations. More research is needed to understand how this relationship varies within and between centers.

federally qualified health center

ambulatory care sensitive conditions

hospitalization

emergency department

younger dual-eligibles

Details

Title: Subtitle: Younger Dual-Eligibles Who Use Federally Qualified Health Centers Have More Preventable Emergency Department Visits, but Some Have Fewer Hospitalizations
Creators: Andrew J Potter - University of Iowa
Amal N Trivedi - Brown University
Brad Wright - University of Iowa
Resource Type: Journal article
Publication Details: Journal of primary care & community health, Vol.8(1), pp.3-8
DOI: 10.1177/2150131916657081
PMID: 27371525
PMCID: PMC5300961
ISSN: 2150-1327
eISSN: 2150-1327
Grant note: L60 MD007506 / NIMHD NIH HHS
Language: English
Date published: 07/01/2016
Academic Unit: Public Policy Center (Archive)
Record Identifier: 9984363560702771

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