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We examined the contribution federally qualified community health centers (CHCs) and rural health clinics (RHCs) may make to the accessibility of primary health care, as measured by county-level rates of hospitalization for ambulatory care sensitive (ACS) conditions. The study used 2002 hospital discharge data from eight states within the US (579 counties) to calculate ACS rates, by age group, at counties with CHC(s) only, RHC(s) only, both (CHC and RHC), and neither. Discharge rates were based on the individual’s county of residence. Among working age adults, the rate ratio (RR) of ACS hospitalization rates in CHC-only counties was 0.86 of the rate at counties with neither facility (95% Confidence Interval, CI, 0.78-0.95). Among older adults, the rate ratio for CHC-only counties compared to counties with neither facility was 0.84 (CI 0.81-0.87); for counties with both CHC and RHC presence, the RR was 0.88 (CI 0.84-0.92). No CHC/RHC effects were found for children or for estimated uninsured populations. These results suggest that CHCs and RHCs may help to limit a county’s rate of hospitalization for ACS diagnoses, particularly among older people.
Contact information:
Jan Probst, PhD
South Carolina Rural Health Research Center
Phone: 803-251-6317
jprobst@mailbox.sc.edu
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