文章基本信息

标题：Methodological Challenges of Measuring Primary Care Delivery to Pediatric Medicaid Beneficiaries Who Use Community Health Centers
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作者：Karen R. Tyo ; Deborah Gurewich ; Donald S. Shepard 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2013
卷号：103
期号：2
页码：273-275
DOI：10.2105/AJPH.2012.300884
语种：English
出版社：American Public Health Association
摘要：Efforts to measure quality of care have focused on ambulatory care providers. We examined the performance of community health centers serving children on Medicaid in 3 states. Descriptive analysis showed considerable patient population heterogeneity, and regression analysis demonstrated that variation explained by the assigned provider was small (mean R² = 4.3%) compared with the variation explained by patient demographic variables (mean R² = 29.9%). The results reinforce the need for caution when one is attributing quality differences to provider performance. Efforts to measure the performance of ambulatory care providers have encountered methodological challenges. 1–4 Patient characteristics have been shown to be an important determinant of outcomes, making risk adjustment difficult. 5–8 The relative contribution of provider-level factors in explaining performance variability has appeared low. 9,10 We used administrative data to explore patient- and provider-level determinants of performance variability within the community health center (CHC) delivery system.