Hoopes Megan J, Angier Heather, Gold Rachel, Bailey Steffani R, Huguet Nathalie, Marino Miguel, DeVoe Jennifer E
OCHIN, Inc, Portland, Oregon (Ms Hoopes); Oregon Health and Science University, Portland, Oregon (Ms Angier, Dr Bailey, Dr Huguet, Dr Marino, and Dr DeVoe)Kaiser Permanente Northwest Center for Health Research, OCHIN, Inc, Portland, Oregon (Dr Gold).
J Ambul Care Manage. 2016 Oct-Dec;39(4):290-8. doi: 10.1097/JAC.0000000000000123.
Using electronic health record data, we examined longitudinal changes in community health center (CHC) visit rates from 2013 through 2014 in Medicaid expansion versus nonexpansion states. Visits from 219 CHCs in 5 expansion states and 4 nonexpansion states were included. Rates were computed using generalized estimating equation Poisson models. Rates increased in expansion state CHCs for new patient, preventive, and limited-service visits (14%, 41%, and 23%, respectively, P < .01 for all), whereas these rates remained unchanged in nonexpansion states. One year after ACA Medicaid expansions, CHCs in expansion states saw an influx of new patients and provided increased preventive services.
利用电子健康记录数据，我们研究了2013年至2014年医疗补助扩大州与非扩大州社区卫生中心（CHC）就诊率的纵向变化。纳入了来自5个扩大州和4个非扩大州的219个社区卫生中心的就诊数据。就诊率使用广义估计方程泊松模型计算。扩大州社区卫生中心的新患者就诊率、预防性就诊率和有限服务就诊率均有所上升（分别为14%、41%和23%，P均<.01），而非扩大州的这些就诊率保持不变。《平价医疗法案》医疗补助扩大一年后，扩大州的社区卫生中心迎来了大量新患者，并提供了更多的预防性服务。
