University of Rochester School of Nursing, Rochester, NY.
Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY.
Nurs Outlook. 2018 May-Jun;66(3):263-272. doi: 10.1016/j.outlook.2018.02.003. Epub 2018 Feb 13.
Federally qualified health centers (FQHCs) were designed to provide care in medically underserved areas. Substantial and sustained federal funding has accelerated FQHC growth.
To examine temporal trends in primary care provider supply and whether FQHCs have been successful in reducing the gap in provider supply in primary care health professional shortage areas (HPSAs).
Retrospective cohort study design using national county-level data from 2009 to 2013. Primary care providers included physicians, nurse practitioners, and physician assistants.
Partial-county HPSAs had the highest average provider supply and the greatest increase, followed by non-HPSA counties and whole-county HPSAs. The provider gap was larger in whole-county HPSAs compared with partial-county HPSAs. Counties with one or more FQHC sites had a smaller provider gap than those without FQHC sites. An increase of one FQHC site was statistically significantly associated with a reduction in the annual provider gap.
FQHCs reduced the gap in primary care provider supply in shortage counties and mitigated uneven distribution of the primary care workforce.
联邦合格的健康中心 (FQHC) 的设计目的是在医疗服务不足的地区提供医疗服务。大量持续的联邦资金加速了 FQHC 的发展。
检查初级保健提供者供应的时间趋势,以及 FQHC 是否成功缩小了初级保健卫生专业人员短缺地区 (HPSA) 供应方面的差距。
使用 2009 年至 2013 年的全国县级数据进行回顾性队列研究设计。初级保健提供者包括医生、执业护士和医师助理。
部分县 HPSA 的平均供应最高,增幅最大,其次是非 HPSA 县和全县 HPSA。与部分县 HPSA 相比,全县 HPSA 的提供者差距更大。拥有一个或多个 FQHC 地点的县比没有 FQHC 地点的县的提供者差距更小。FQHC 地点增加一个与每年提供者差距的减少具有统计学意义相关。
FQHC 缩小了短缺县初级保健提供者供应方面的差距,并缓解了初级保健劳动力分布不均的问题。