Abstract
BackgroundCare of the underserved remains one of the most compelling challenges to American healthcare. Federally Qualified Health Centers (FQHCs) address uninsurance and underinsurance by providing primary and preventive care to vulnerable populations with fees charged based on ability to pay. Our goal is to study the effectiveness of FQHCs system in engaging patients and the barriers to utilization, which have not been well defined.MethodsRetrospective analysis was performed on data from “Living for Health” (L4H) program participants from 2008 to 2012. Univariate and multivariate logistic regression analysis were performed to determine factors associated with FQHC utilization.ResultsAmong 9453 subjects screened, 1889 were referred to a FQHC, but only 201(11%) actually sought treatment. Public insurance, non-Hispanic ethnicity, and hypertension were associated with higher rates of FQHC utilization. Inability to afford costs, cultural factors and inflexible appointment times were the most common reasons for FQHC underutilization.ConclusionThe current status of FQHC utilization is sub-optimal. Community outreach programs like L4H can improve the access and utilization of FQHCs.
Highlights
Care of the underserved remains one of the most compelling challenges to American healthcare
In an analysis of National Health Institute Survey data 1997-2006, Hoffman and Schwartz reviewed over 76,000 non-elderly adults who were known to have at least one major chronic disease. They collected the data on participants’ insurance status and access of care, reporting 34.4% of uninsured had no usual source of medical care, 25.8% had no doctor visit in the last year and over 81% reported no specialist visit in the last year [6]
Our main goal in the current study is to evaluate the degree of Federally Qualified Health Centers (FQHCs) utilization and identify areas of potential improvement to better serve the poor and underserved
Summary
Care of the underserved remains one of the most compelling challenges to American healthcare. In an analysis of National Health Institute Survey data 1997-2006, Hoffman and Schwartz reviewed over 76,000 non-elderly adults who were known to have at least one major chronic disease. They collected the data on participants’ insurance status and access of care, reporting 34.4% of uninsured had no usual source of medical care, 25.8% had no doctor visit in the last year and over 81% reported no specialist visit in the last year [6]. It is worth-mentioning that lack of primary care can result in increased emergency room use and increased health care costs [7,8]
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