2012/2013 年至 2016 年期间社区卫生中心初级保健服务可及性的变化。
Changes in primary care access at community health centers between 2012/2013 and 2016.
机构信息
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Rollins School of Public Health, Emory University, Atlanta, Georgia.
出版信息
Health Serv Res. 2019 Feb;54(1):181-186. doi: 10.1111/1475-6773.13082. Epub 2018 Nov 5.
OBJECTIVE
To compare access at community health centers (CHCs) vs private offices (non-CHCs) under the Affordable Care Act.
DATA SOURCE
Ten state primary care audit conducted in 2012/2013 and 2016.
STUDY DESIGN
CHCs and non-CHCs were called. We calculated difference in differences comparing CHCs vs non-CHCs by caller insurance type.
PRINCIPAL FINDINGS
In both rounds, Medicaid and uninsured callers had higher appointment rates at CHC than non-CHCs. CHC appointment rates significantly increased between 2012/2013 and 2016 for both employer-sponsored and Medicaid callers, with no significant wait time changes. Appointment rates increased (13.5% points, P < 0.001) and wait times decreased (-5.7 days, P = 0.017) at CHCs relative to non-CHCs for employer-sponsored insurance.
CONCLUSION
Appointment availability at CHCs improved after ACA implementation, without increased wait times.
目的
比较平价医疗法案下社区卫生中心（CHC）与私人诊所（非 CHC）的就诊机会。
资料来源
2012/2013 年和 2016 年进行的十项州初级保健审计。
研究设计
呼叫者拨打 CHC 和非 CHC。我们通过呼叫者的保险类型计算 CHC 与非 CHC 的差异。
主要发现
在两轮中，医疗补助和无保险的呼叫者在 CHC 的预约率均高于非 CHC。2012/2013 年至 2016 年，雇主赞助和医疗补助的呼叫者在 CHC 的预约率均显著增加，而等待时间没有明显变化。与非 CHC 相比，雇主赞助保险的 CHC 的预约率增加（13.5%，P<0.001），等待时间减少（-5.7 天，P=0.017）。
结论
平价医疗法案实施后，CHC 的就诊机会得到改善，而等待时间没有增加。
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