The economic benefits of community health centers in lowering preventable hospitalizations: a cost-effectiveness analysis

摘要

Research has suggested that accessible primary healthcare may help control hospitalization for certain conditions that are often considered either preventable or treatable through primary healthcare. However, only limited research has tested this widely accepted hypothesis. We extend research on preventable hospitalization in the framework of cost-effectiveness analysis. Using hospitalization data from South Carolina, we show how access to primary healthcare may affect the volume and cost of hospitalizations for ambulatory care sensitive conditions. Our statistical models for effectiveness and cost take advantage of spatial methods to adjust for neighborhood characteristics. This adjustment also addresses correlations among variables describing each given area, providing appropriate results despite those correlations. We also use propensity scores to adjust for county level variation in access to primary healthcare. We observe that the mean differential volume and cost of lower extremity amputation associated with diabetes was significantly lower in areas served by community health centers than in other areas. This result provides support for the hypothesis that increasing access to primary healthcare may help to control the volume and cost of preventable hospitalization for some conditions.