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Association Between Community Health Center Usage and Emergency Department Utilization among California's HIV-Infected Medicaid Beneficiaries, 2009.

紀錄類型:	書目-電子資源 : Monograph/item
書名/作者:	Association Between Community Health Center Usage and Emergency Department Utilization among California's HIV-Infected Medicaid Beneficiaries, 2009.
作者:	Chow, Jeremy Yan-Shun.
出版者:	Ann Arbor : : ProQuest Dissertations & Theses, , 2016
面頁冊數:	35 p.
附註:	Source: Masters Abstracts International, Volume: 55-05.
Contained By:	Masters Abstracts International55-05(E).
標題:	Medicine.
標題:	Health sciences.
ISBN:	9781339808857
摘要、提要註:	Importance: Community Health Centers (CHC) are important sites of care for people living with HIV (PLWH) and play an increasing role in their care under the Affordable Care Act. Little is known about the relationship between CHC usage and emergency department (ED) utilization in this population.

Association Between Community Health Center Usage and Emergency Department Utilization among California's HIV-Infected Medicaid Beneficiaries, 2009.
Chow, Jeremy Yan-Shun.

Association Between Community Health Center Usage and Emergency Department Utilization among California's HIV-Infected Medicaid Beneficiaries, 2009. - Ann Arbor : ProQuest Dissertations & Theses, 2016 - 35 p.

Source: Masters Abstracts International, Volume: 55-05.

Thesis (M.S.)--University of California, Los Angeles, 2016.

This item is not available from ProQuest Dissertations & Theses.

Importance: Community Health Centers (CHC) are important sites of care for people living with HIV (PLWH) and play an increasing role in their care under the Affordable Care Act. Little is known about the relationship between CHC usage and emergency department (ED) utilization in this population.

ISBN: 9781339808857Subjects--Topical Terms:

373206
Medicine.

Association Between Community Health Center Usage and Emergency Department Utilization among California's HIV-Infected Medicaid Beneficiaries, 2009.
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020 $a 9781339808857
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100 1 $a Chow, Jeremy Yan-Shun. $3 686765
245 1 0 $a Association Between Community Health Center Usage and Emergency Department Utilization among California's HIV-Infected Medicaid Beneficiaries, 2009.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2016
300 $a 35 p.
500 $a Source: Masters Abstracts International, Volume: 55-05.
500 $a Adviser: Marc Adam Suchard.
502 $a Thesis (M.S.)--University of California, Los Angeles, 2016.
506 $a This item is not available from ProQuest Dissertations & Theses.
520 $a Importance: Community Health Centers (CHC) are important sites of care for people living with HIV (PLWH) and play an increasing role in their care under the Affordable Care Act. Little is known about the relationship between CHC usage and emergency department (ED) utilization in this population.
520 $a Objective: To determine the association between CHC usage and ED utilization.
520 $a Design: Retrospective, cross-sectional study of diagnosed PLWH enrolled in California's Medicaid program in 2008 and 2009. Zero-inflated Poisson models were used to estimate the odds of being an ED user and the number of ED visits in 2009. We controlled for demographics (age, gender, race, urban residence, income, education), service characteristics (managed care enrollment, provider HIV experience), and medical characteristics (mental health, substance abuse, tobacco, medical comorbidity, antiretroviral therapy).
520 $a Setting: Emergency department.
520 $a Participants: We included 6284 adult, full-term 2008-2009 beneficiaries with strong evidence of HIV diagnosis and excluded pregnant and dual-eligible beneficiaries.
520 $a Exposures: CHC users were patients who had ≥1 CHC outpatient claim in 2008. Non-CHC users had outpatient claims only at non-CHCs. Those with no outpatient usage had no 2008 outpatient claims.
520 $a Main Outcomes and Measures: Number of ED claims on separate days per beneficiary in 2009.
520 $a Results: CHC users averaged significantly greater numbers of ED visits than non-CHC users and those with no outpatient usage (1.91, 1.58, and 1.70, respectively; P=0.022). CHC users had higher odds of being ED users (OR=1.16; 95%CI 1.04-1.30). Controlling for demographic and service characteristics did not alter this result (OR=1.16; 95%CI 1.03-1.31). The difference was mitigated once medical characteristics were included (OR=1.09; 95%CI 0.96-1.25). The association between CHC status and number of ED visits, conditional on using the ED at all, was not significant in the bivariate (rate ratio (RR)= 1.12; 95%CI 0.97-1.28) or multivariate models (RR=1.01; 95%CI 0.87-1.17). The overall differences in mean ED visits observed between CHC and non-CHC groups were reduced to insignificance (1.77; 95% CI 1.60-1.93 vs 1.68; 95%CI 1.53-1.84) after adjusting for demographic, service, and medical characteristics.
520 $a Conclusions and Relevance: CHC users had higher ED utilization than non-CHC users, but the disparity was largely driven by differences in medical characteristics.
590 $a School code: 0031.
650 4 $a Medicine. $3 373206
650 4 $a Health sciences. $3 630104
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793 $a English