当患者做主时：联邦拨款与联邦合格医疗中心的无偿医疗服务
When patients govern: federal grant funding and uncompensated care at federally qualified health centers.
作者信息
Wright Brad, Ricketts Thomas C
机构信息
Center for Gerontology and Healthcare Research, Brown University, Providence, RI 02912, USA.
出版信息
J Health Care Poor Underserved. 2013 May;24(2):954-67. doi: 10.1353/hpu.2013.0068.
OBJECTIVE
To determine if the proportion of consumers on federally qualified health center (FQHC) governing boards is associated with their use of federal grant funds to provide uncompensated care.
METHODS
Using FQHC data from the Uniform Data System, county-level data from the Area Resource File and governing board data from FQHC grant applications, the uncompensated care an FQHC provides relative to the amount of its federal funding is modeled as a function of board and executive committee composition using fixed-effects regression with FQHC and county-level controls.
RESULTS
Consumer governance does not predict how much uncompensated care an FQHC provides relative to the size of its federal grant. Rather, the proportion of an FQHC's patient-mix that is uninsured drives uncompensated care provision.
CONCLUSIONS
Aside from a small executive committee effect, consumer governance does not influence FQHCs' provision of uncompensated care. More work is needed to understand the role of consumer governance.
目的
确定联邦合格医疗中心（FQHC）管理委员会中消费者的比例是否与其使用联邦拨款资金提供无偿医疗服务有关。
方法
利用统一数据系统中的FQHC数据、区域资源文件中的县级数据以及FQHC拨款申请中的管理委员会数据，通过固定效应回归模型，将FQHC提供的无偿医疗服务相对于其联邦资金数额建模为管理委员会和执行委员会组成的函数，并纳入FQHC和县级控制变量。
结果
消费者治理并不能预测FQHC相对于其联邦拨款规模提供的无偿医疗服务量。相反，FQHC患者组合中未参保者的比例驱动了无偿医疗服务的提供。
结论
除了执行委员会的微小影响外，消费者治理并不影响FQHC提供无偿医疗服务。需要开展更多工作来了解消费者治理的作用。
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