TABLE 3—
Use and Expense for Health Center Patients Compared With Matched Physician Office, Hospital Outpatient, and Mixed Use Patients: United States, 2009
| Physician Office (n = 144 074) |
Hospital Outpatient (n = 144 071) |
Mixed Usea (n = 144 074) |
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| Utilization or Cost | Health Center (n = 144 076), Estimate (95% CI) | Estimate (95% CI) | Difference From Health Center, % (95% CI)b | Estimate (95% CI) | Difference From Health Center, % (95% CI)b | Estimate (95% CI) | Difference From Health Center, % (95% CI)b |
| Primary care | |||||||
| Visits, no. | 7.6 (7.6, 7.7) | 7.6 (7.6, 7.7) | 0 (–1, 0) | 7.7 (7.7, 7.8) | −1 (–2, −1) | 8.6 (8.6, 8.7) | −12 (–12, −11) |
| Spending, $ | 1 430 (1 418, 1 442) | 1 184 (1 158, 1 211) | 21 (18, 24) | 1 974 (1 944, 2 004) | −28 (–29, −26) | 2 315 (2 283, 2 347) | −38 (–39, −37) |
| Other outpatient carec | |||||||
| Visits, no. | 12.2 (12, 12.5) | 14.4 (14.2, 14.7) | −15 (–17, −13) | 13.5 (13.3, 13.7) | −9 (–11, −7) | 18.5 (18.2, 18.8) | −34 (–35, −32) |
| Spending, $ | 1 970 (1 935, 2 006) | 2 842 (2 787, 2 897) | −31 (–32, −29) | 3 066 (3 015, 3 117) | −36 (–37, −34) | 3 170 (3 125, 3 217) | −38 (–39, −36) |
| Prescription drug spending, $ | 2 324 (2 296, 2 352) | 2 716 (2 680, 2 752) | −14 (–16, −13) | 3 051 (2 964, 3 140) | −24 (–26, −21) | 2 709 (2 673, 2 746) | −14 (–16, −13) |
| Emergency department | |||||||
| Visits, no. | 1.2 (1.2, 1.2) | 1 (1, 1) | 16 (14, 18) | 2.6 (2.5, 2.6) | −54 (–54, −53) | 1.4 (1.4–1.4) | −13 (–15, −12) |
| Spending, $ | 216 (213, 219) | 186 (184, 189) | 16 (13, 18) | 480 (473, 486) | −55 (–56, −54) | 249 (245, 252) | −13 (–15, −11) |
| Inpatient | |||||||
| Admissions, no. | 0.19 (0.19, 0.20) | 0.22 (0.21, 0.22) | −11 (–14, −8) | 0.60 (0.59, 0.61) | −68 (–69, −67) | 0.24 (0.24, 0.25) | −21 (–23, −19) |
| Length of stay,d d | 0.8 (0.8, 0.9) | 0.9 (0.9, 0.95) | −9 (–13, −4) | 2.8 (2.7, 2.9) | −70 (–71, −69) | 1.11 (1.1, 1.1) | −24 (–27, −20) |
| Spending, $ | 1 496 (1 446, 1 548) | 1 757 (1 702, 1 814) | −15 (–19, −11) | 4 908 (4 799, 5 018) | −70 (–71, −68) | 1 893 (1 834, 1 953) | −21 (–24, −17) |
| Total spending, $ | 7 530 (7 452, 7 609) | 8 791 (8 691, 8 891) | −14 (–16, −13) | 13 629 (13 467, 13 793) | −45 (–46, −44) | 10 439 (10 337, 10 542) | −28 (–29, −27) |
Note. CI = confidence interval. Primary care setting is determined by where > 50% of primary care visits occur. Use and spending is expressed in annual values per patient. Each health center patient was matched with 1 patient from the physician office, hospital outpatient, and mixed use settings on the basis of the logit of propensity score, which was estimated using a multinomial logistic regression adjusting for patient demographics (age, race/ethnicity, gender), insurance characteristics (Medicaid eligibility category, months of eligibility, Temporary Aid for Needy Families program beneficiary indicator), disease burden (on the basis of binary disease diagnosis variables from the Chronic Illness and Disability Payment System), state, residence in a metropolitan statistical area, and distance from the closest health center delivery site.
Mixed use indicates enrollees, where no single setting accounts for > 50% of primary care visits.
The negative percentage difference reflects lower health center utilization or spending.
Other outpatient care is defined as all nonprimary care, nontransportation, and nondental outpatient claims activity.
Total annualized inpatient length of stay in days.