@article{TEXTUAL,
      recid = {6119},
      author = {Myong, Catherine and Hull, Peter and Price, Mary and Hsu,  John and Newhouse, Joseph P. and Fung, Vicki},
      title = {The impact of funding for federally qualified health  centers on utilization and emergency department visits in  Massachusetts},
      journal = {PLOS ONE},
      address = {2020-12-03},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Importance: Federally qualified health centers (FQHCs)  receive federal funding to serve medically underserved  areas and provide a range of services including  comprehensive primary care, enabling services, and  behavioral health care. Greater funding for FQHCs could  increase the local availability of clinic-based care and  help reduce more costly resource use, such as emergency  department visits (ED).&lt;/p&gt; &lt;p&gt;Objective: To examine the  impact of funding increases for FQHCs after the ACA on the  use of FQHCs and EDs.&lt;/p&gt; &lt;p&gt;Methods: Retrospective study  using the Massachusetts All Payer Claims Database (APCD)  2010–2013 that included APCD enrollees in 559 Massachusetts  ZIP codes (N = 6,173,563 in 2010). We calculated  shift-share predictions of changes in FQHC funding at the  ZIP code-level for FQHCs that received Community Health  Center funds in any year, 2010–13 (N = 31). Outcomes were  the number of ZIP code enrollees with visits to FQHCs and  EDs, overall and for emergent and non-emergent  diagnoses.&lt;/p&gt; &lt;p&gt;Results: In 2010, 4% of study subjects  visited a FQHC, and they were more likely to be younger,  have Medicaid, and live in low-income areas. We found that  a standard deviation increase in prior year FQHC funding  (+31 percentage point (pp)) at the ZIP code level was  associated with a 2.3pp (95% CI 0.7pp to 3.8pp) increase in  enrollees with FQHC visits and a 1.3pp (95% CI -2.3pp to  -0.3pp) decrease in enrollees with non-emergent ED visits,  but no significant change in emergent ED visits (0.3pp, 95%  CI -0.8pp to 1.4pp).&lt;/p&gt; &lt;p&gt;Conclusions: We found that  areas exposed to greater FQHC funding increases had more  growth in the number of enrollees seen by FQHCs and greater  reductions in ED visits for non-emergent conditions.  Investment in FQHCs could be a promising approach to  increase access to care for underserved populations and  reduce costly ED visits, especially for primary care  treatable or non-emergent conditions.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/6119},
}