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At least 19 recordsLinked to original sources
PubMed2001

Primary care of patients without insurance by community health centers.

Community health centers (CHCs) are in a strong position to meaningfully contribute to health promotion, early detection, and improvement in health care outcomes for some of the most vulnerable person in the nation, since almost one in three users of federally funded CHCs was uninsured in 1994. The purpose of this article is to compare uninsured CHC users with uninsured people nationwide. Data for the analysis came primarily from two population-based surveys: the 1994 National Health Interview Survey (NHIS) and the 1995 Community Health Center (CHC) User Survey.

Adolescent↗
PubMed2005

A record linkage protocol for a diabetes registry at ethnically diverse community health centers.

Community health centers serve ethnically diverse populations that may pose challenges for record linkage based on name and date of birth. The objective was to identify an optimal deterministic algorithm to link patient encounters and laboratory results for hemoglobin A1c testing and examine its variability by health center site, patient ethnicity, and other variables. Based on data elements of last name, first name, date of birth, gender, and health center site, matches with >/=50% to < 100% of a maximum score were manually reviewed for true matches. Match keys based on combinations of name substrings, date of birth, gender, and health center were used to link encounter and laboratory files. The optimal match key was the first two letters of the last name and date of birth, which had a sensitivity of 92.7% and a positive predictive value of 99.5%. Sensitivity marginally varied by health center, age, gender, but not by ethnicity. An algorithm that was inexpensive, accurate, and easy to implement was found to be well suited for population-based measurement of clinical quality.

Adult↗
PubMed2006

Challenges to research in urban community health centers.

Community health centers (CHCs) are important settings for research aimed at reducing health disparities. However, CHCs pose many challenges to research at patient, provider, and system levels. We summarized lessons learned from a multimethod, formative study to develop intervention strategies for improving colorectal cancer screening in CHCs, and make recommendations for future research. The call for research in "real world" settings such as CHCs must be matched with greater understanding of the challenges, as well as the resources to meet those challenges.

Black or African American↗
PubMedDate not supplied

The quality of chronic disease care in U.S. community health centers.

Community health centers (CHCs) are responsible for providing care for more than fifteen million Americans, many of whom are members of groups who have been documented to receive low-quality care. This study examines the quality of care for patients with chronic disease in a nationally representative sample of federally funded CHCs. Fewer than half of eligible patients received appropriate care for the majority of indicators measured, and uninsured patients received poorer care than insured patients. Although the quality of chronic disease care in CHCs compares favorably with that of care received in other settings, gaps in quality were observed for the uninsured.

Chronic Disease↗
PubMed1995

How an academic health center and a community health center found common ground.

Despite their divergent missions, academic health centers (AHCs) and community health centers (CHCs) are natural partners. This is becoming more obvious as national attention is focused on greatly increasing the number of primary care providers. AHCs are responding to this pressure and now need more sites to train primary care physicians, and CHCs need more primary care physicians (the AHCs' graduates) as staff. Thus these two types of institutions have a common interest. Other major themes of health care reform are also likely to drive AHCs and CHCs together, such as providing access to the uninsured, placing more emphasis on prevention and public health, and coordinating care in managed care systems to improve outcomes and control costs. Yet partnerships between these two kinds of institutions are still rare. This article describes a successful joint program begun in 1991 between the Lincoln Heights Health Center, which serves a poor, predominantly black community, and the University of Cincinnati Medical Center. All the program's activities are monitored by a policy committee made up of representatives from both institutions. For the first five years, the main hospital of the medical center is supporting the relationship with a $350,000 grant. Both parties retain their independent governance, yet collaborate closely and feel the relationship yields high value to each party and the community. For example, medical education in out-of-hospital settings has increased greatly, as have referrals to the AHC. The CHC has been able to recruit and retain high-quality physicians; its balance sheet has been favorably affected also.(ABSTRACT TRUNCATED AT 250 WORDS)

Academic Medical Centers↗
PubMedDate not supplied

Glycemic control in diabetic patients served by community health centers.

The Community Health Center Network measured the prevalence of glycemic control in diabetic patients at 7 community health centers as part of its clinical quality improvement program. A cross-sectional survey was carried out in a random sample of 1817 diabetic patients having 1 or more encounters from October 1, 2000 to September 30, 2001. Computerized laboratory results for hemoglobin A1c (HbA1c) tests were available for half the sample. Manual review of medical charts was carried out for the rest. The proportion of diabetic patients with 1 or more HbA1c tests in the measurement year was 91% (CI95%: 90-93%) and poor glycemic control (HbA1c > 9%) occurred in 27% (CIM%: 25-30%). The mean of the most recent test was 7.8%. The frequency of testing varied significantly by clinic from 79% to 94% and increased with the number of encounters. Poor glycemic control also varied significantly by clinic (17-48%) and was significantly better in females and older patients. Measures of glycemic control were not associated with ethnicity or insurance status in multivariate analyses. A high proportion of diabetic patients received appropriate care, and this care was not associated with ethnicity or insurance status. The data warehouse was an essential tool for the clinical quality improvement program.

Adolescent↗
PubMed1998

[A method for quality assurance in a community mental health center. Community psychiatry in Copenhagen].

The purpose was to describe a method for quality assurance in community mental health centres. Three psychiatrists and a multiprofessional treatment team conceived the method. The community mental health center--which was the basis for the work--was the Copenhagen centre for the sectors Vesterbro and Kongens Enghave. The target group for the centre is people with serious mental illness. The work is done according to the principles for clinical case managers. Data are registered in a national database in combination with the centre's own registration system. Eleven indicators for process quality and eight for outcome quality were selected. Measurement parameters for there indicators were defined. Criteria and standard were defined according to existing knowledge and the author's clinical experience. The necessary programs for calculating the value of the chosen standards are constructed. With the use of existing data and a limited extra registration it was possible to evolve a method for quality assurance in a community mental health centre.

Case Management↗
PubMedDate not supplied

Computerized prompts for cancer screening in a community health center.

BACKGROUND: We describe the implementation and subsequent use of a computerized health maintenance tracking system in a large, urban, North Carolina community health center (Lincoln Community Health Center) as part of a larger study designed to increase rates of mammography, Papanicolaou tests, and smoking cessation in low-income African-Americans. METHODS: Clinicians from the Lincoln Community Health Center were involved in the design and implementation of the computer system. At each office visit, clinicians received a computerized encounter form indicating needed screening tests, counseling, and immunizations for each randomly selected study patient (n = 1318). RESULTS: Initial clinician compliance rates with filling out the form were 95 percent (mammography), 82 percent (Papanicolaou test), 77 percent (clinician breast examination), and 55 percent (smoking cessation). Cumulative compliance leveled off at 21 months to 65 percent, 57 percent, 53 percent, and 38 percent, respectively, despite multiple reminder strategies. When surveyed, most clinicians thought it was a good reminder system but said they did not always complete the form because of time demands. Costs of adapting and implementing the system were $23,332.08 ($17.70 per study). Per-patient costs would have been reduced further if more patients had been included in the project. CONCLUSIONS: State-of-the-art computer prompting systems can be useful in a community health center; however, even with prompting, clinicians still only addressed health maintenance with their patients about 50 percent of the time. Additional interventions will be needed, particularly in low-income populations, to meet the Healthy People 2000 goals in health promotion.

Adolescent↗
PubMed1996

[Supporting roles of health centers in community health practice by municipalities].

Staff of community health centers are expected to support those of municipalities so that they can identify health relevant issues in their communities, plan strategies to resolve the issues, implement them and evaluate the action. To illustrate the role of community health centers, the authors report the process of health promotion practice in Taisho-cho, Kochi prefecture, which was supported by Kubokawa health center. The health center took the initiative in identifying issues in community health through analyzing available information. In a practice setting, the health center facilitated involvement and participation by the residents and cooperated with other community resources. The process of support is discussed from the point of view of community organization practice.

Ambulatory Care Facilities↗
PubMed2001

Collaboration between an internal medicine residency program and a federally qualified health center: Norwalk Hospital and the Norwalk Community Health Center.

In 1999, Norwalk Hospital and an independent, community-based board collaboratively developed the Norwalk Community Health Center (the NCHC). The objectives of the affiliation were to (1) create a new, free-standing, high-quality community health center, (2) optimize grant and clinical revenue, (3) create an ideal venue for ambulatory care training for residents, and (4) replace the traditional and increasingly inefficient hospital-based primary care clinics. The hospital transferred all of its primary care clinical activity to the new community health center and provides an ongoing financial subsidy of the NCHC operations via a forgivable loan. In exchange, the NCHC granted Norwalk Hospital 24% of the seats on its board of directors and purchases all primary care provider services from the hospital. For adult medicine, the contract providers are exclusively Norwalk Hospital internal medicine residents and faculty. Contract charges are based not upon actual staffing but upon a standard formula relating full-time-equivalent providers to patient visits. The new 10,000 square-foot NCHC contains 2,500 square feet of additional integrated space, rented from the NCHC by Norwalk Hospital, which supports the residency education program. The NCHC opened in April 1999 and received FQHC status in November 1999. Adult medicine volume increased 30%, from 36.8 daily visits in the old hospital-based clinics to 48.0 at the NCHC. Resident and patient satisfaction are high. The NCHC now receives cost-based visit reimbursement from Medicaid and has received $1.8 million in state, federal, and local grants.

Adult↗