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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

Role of community health outreach program “living for health”® in improving access to federally qualified health centers in Miami-dade county, Florida: a cross-sectional study

Authors: Aws Almufleh, Tori Gabriel, Laura Tokayer, Mary Comerford, Ahmed Alaqeel, Paul Kurlansky

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

Care 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.

Methods

Retrospective 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.

Results

Among 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.

Conclusion

The current status of FQHC utilization is sub-optimal. Community outreach programs like L4H can improve the access and utilization of FQHCs.
Literature
1.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Executive summary: heart disease and stroke statistics–2014 update: a report from the American Heart Association. Circulation. 2014;129(3):399–410.CrossRefPubMed
2.
Egan BM, Li J, Qanungo S, Wolfman TE. Blood pressure and cholesterol control in hypertensive hypercholesterolemic patients: national health and nutrition examination surveys 1988-2010. Circulation. 2013;128(1):29–41.CrossRefPubMedPubMedCentral
3.
Asplin BR. Tying a knot in the unraveling health care safety net. Acad Emerg Med. 2001;8(11):1075–9.CrossRefPubMed
4.
Epstein AJ. The role of public clinics in preventable hospitalizations among vulnerable populations. Health Serv Res. 2001;2:36.
5.
Wood SGD, Bruen B, Johnson K, Mead H. Community Health Centers in an Era of Health Reform: An Overview and Key Challenges to Health Center Growth. Health Policy Faculty Publications. 2013;1:1.
6.
Hoffman C, Schwartz K. Eroding access among nonelderly U.S. adults with chronic conditions: ten years of change. Health Aff (Millwood). 2008;27(5):w340–8.CrossRef
7.
Douangmala CS, Hayden SA, Young LE, Rho J, Schnepper LL. Factors influencing healthcare utilization within a free community clinic. J Immig Minor Health. 2012;14(4):698–705.CrossRef
8.
Coyne CA, Demian-Popescu C, Friend D. Social and cultural factors influencing health in southern West Virginia: a qualitative study. Prev Chronic Dis. 2006;3(4):A124.PubMedPubMedCentral
9.
Katz AB, Felland LE, Hill I, Stark LB. A long and winding road: federally qualified health centers, community variation and prospects under reform. Res Brief. 2011;21:1–9.PubMed
10.
Money Jr EB. Federally qualified health center expansion through the Affordable Care Act. N C Med J. 2013;74(4):325–6.PubMed
11.
Smith-Campbell B. Emergency department and community health center visits and costs in an uninsured population. J Nurs Scholarsh. 2005;37(1):80–6.CrossRefPubMed
12.
Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc. 1973;51(1):95–124.CrossRefPubMed
13.
Pieh-Holder KL, Callahan C, Young P. Qualitative needs assessment: healthcare experiences of underserved populations in Montgomery County, Virginia, USA. Rural Remote Health. 2012;12:1816.PubMed
14.
Wright DB. Consumer governance and the provision of enabling services that facilitate access to care at community health centers. Med Care. 2012;50(8):668–75.CrossRefPubMed
15.
16.
Hoffman C, Paradise J. Health insurance and access to health care in the United States. Ann N Y Acad Sci. 2008;1136:149–60.CrossRefPubMed
17.
18.
Cruz RHR. Miami-Dade County Economic & Demographic Profile. Miami: Miami-Dade County, Miami Dept of Regulatory & Economic Resources Economic Analysis & Policy; 2013.
19.
Shi L, Lebrun-Harris LA, Daly CA, Sharma R, Sripipatana A, Hayashi AS, et al. Reducing disparities in access to primary care and patient satisfaction with care: the role of health centers. J Health Care Poor Underserved. 2013;24(1):56–66.CrossRefPubMed
Metadata
Title
Role of community health outreach program “living for health”® in improving access to federally qualified health centers in Miami-dade county, Florida: a cross-sectional study
Authors
Aws Almufleh
Tori Gabriel
Laura Tokayer
Mary Comerford
Ahmed Alaqeel
Paul Kurlansky
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0826-z

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