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Association Between Community Health...

Chow, Jeremy Yan-Shun.

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

Record Type:	Electronic resources : Monograph/item
Title/Author:	Association Between Community Health Center Usage and Emergency Department Utilization among California's HIV-Infected Medicaid Beneficiaries, 2009./
Author:	Chow, Jeremy Yan-Shun.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2016,
Description:	35 p.
Notes:	Source: Masters Abstracts International, Volume: 55-05.
Contained By:	Masters Abstracts International55-05(E).
Subject:	Medicine. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10119665
ISBN:	9781339808857

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:

641104
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
035 $a (MiAaPQ)AAI10119665
035 $a AAI10119665
040 $a MiAaPQ $c MiAaPQ
100 1 $a Chow, Jeremy Yan-Shun. $3 3280675
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 641104
650 4 $a Health sciences. $3 3168359
690 $a 0564
690 $a 0566
710 2 $a University of California, Los Angeles. $b Clinical Research. $3 3182904
773 0 $t Masters Abstracts International $g 55-05(E).
790 $a 0031
791 $a M.S.
792 $a 2016
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10119665