The Quality Of Chronic Disease Care In U.S. Community Health Centers

Abstract

Community health centers (CHCs) are responsible for providing care for more than fifteen million Americans, many of whom are members of groups who have been documented to receive low-quality care. This study examines the quality of care for patients with chronic disease in a nationally representative sample of federally funded CHCs. Fewer than half of eligible patients received appropriate care for the majority of indicators measured, and uninsured patients received poorer care than insured patients. Although the quality of chronic disease care in CHCs compares favorably with that of care received in other settings, gaps in quality were observed for the uninsured. 1 These issues are of particular concern for publicly supported community health centers (CHCs), which are responsible for caring for more than fifteen million Americans, 23 percent of whom are uninsured and 64 percent of whom are members of immigrant or minority groups. Such groups have been previously documented to receive lowerquality care than insured, nonimmigrant/minority patients receive. D a t a W a t c h

Electronic Health Records vs Medicaid Claims: Completeness of Diabetes Preventive Care Data in Community Health Centers

“…9,10,14,16,18,23,35,36 Our fi ndings show how EHR data from CHC networks provide a new resource for policy makers to better understand health services delivery in CHC populations. 10,15,16,[37][38][39][40] Policy makers and payers need to look beyond Medicaid claims data to measure population health and CHC quality performance.…”

“…Although our rates are comparable to available estimates from nationally representative data, 16 directly comparing rates of receipt of care measures with those of other populations was not feasible, as previous assessments varied in how receipt of care was measured and how populations were defi ned. [14][15][16][17]23,38,51 This analysis was done in one state, but it could be replicated in other states with similar CHC networks.…”

“…Community health centers (CHCs) provide services to such uninsured populations [9][10][11][12][13][14][15] ; thus, their medical records include information about receipt of care that would not be captured in claims data. Until recently, however, studies of services received in CHCs have been limited to labor-intensive audits of paper medical records, or the collection of primary data from patient surveys.…”

Strategies and Considerations for Community-Based Participatory Research in the Prevention of Type 2 Diabetes in Youth

“…These relationships should be maintained even in the absence of ongoing funded research studies. [14][15][16] Academic researchers can also help community organizations secure federal, state, and private funding to continue health promotion programs that appeal to youth and families.…”

“…Publishing the results in a local community paper or presenting the data during a community event are examples of ways to inform the community of the outcomes of the study. [14][15][16] Call to Action Several socioeconomic issues, including lack of formal education, low income, racial/ethnic discrimination, neighborhood crime, lack of health insurance coverage, and limited access to healthy foods, contribute to health disparities in underserved communities. 17 Because lifestyle changes for families from underserved communities may be influenced more by societal factors than by individual will, a populationhealth approach that includes social and environmental changes may be very effective in promoting healthy living.…”