Performance Improvement 2005. Examination of Ambulatory CARE Sensitive Conditions, Using the State Medicaid Statistical Files: Adverse Events (admissions and Emergency Visits), Comparisons by Usual Source of CARE


The purpose of this study was to compare episodes of ambulatory care for Federally Qualified Health Center (FQHC) users to those of non-FQHC users when both have been hospitalized with a primary diagnosis of diabetes, hypertension, asthma, or other ambulatory care sensitive conditions, as well as when neither has been hospitalized. A consensus conference in December, 1995 recommended the use of Medicaid data to examine changes in utilization patterns for FQHC patients diagnosed with ambulatory care sensitive conditions. These are conditions which frequently can be managed with timely and effective treatment in outpatient settings, thus preventing the need for hospitalization. The study found that the likelihood of experiencing a hospitalization or emergency room visit was related to differences in type of health care provided, race/ethnicity and gender of patient, and co-morbidity. (A previous study, see PIC #6001, showed that Medicaid beneficiaries who received most of their care from FQHCs had lower hospitalization rates for ACSCs than did non-FQHC users.)

PIC ID: 7127; Agency Sponsor: HRSA-BPHC, Bureau of Primary Health Care; Federal Contact: Wells, Barbara, 301-594-4463; Performer: MDS Associates, Inc., Wheaton, MD

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