Community Health Center and Rural Health Clinic Presence Associated with Lower County-Level Hospitalization Rates for Ambulatory Care Sensitive Conditions.

摘要

We examined the effect of the presence of a federally qualified community health center (CHC) or rural health clinic (RHC) within a county on population rates of hospitalization for ambulatory care sensitive (ACS) conditions, using data from eight states. ACS conditions are diagnoses for which, in the judgment of medical experts, access to primary care should reduce the frequency of hospitalization. CHC or RHC availability did not affect ACS hospitalization rates among children, either for all children or among uninsured children alone. For working age adults, the presence of a CHC in the county of residence was associated with decreased rates for ACS hospitalizations, when compared to a county with neither facility. Among older adults, the presence of either a CHC or an RHC, or both, in the county reduced ACS admission rates, compared to counties in which neither provider was present. Results suggest that CHCs and RHCs may play a useful role in providing rural adults with access to primary health care and help to reduce rates of ambulatory care sensitive conditions. Further research is needed to understand the role of CHCs and RHCs in supporting access to care for children.