Cargando…

Disparities in Referral Initiation and Completion at an Urban FQHC Look-alike (FQHC-LA) Clinic

INTRODUCTION: The purpose of this study was to determine referral initiation and completion disparities across primary care encounters at the Hope Family Care Center (HFCC) in Kansas City, MO, by payor type (primary insurance): private insurance, Medicaid, Medicare, and self-pay. METHODS: Data were...

Descripción completa

Detalles Bibliográficos
Autores principales: Emerson, Amanda K., Hughes, Dorothy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: University of Kansas Medical Center 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241200/
https://www.ncbi.nlm.nih.gov/pubmed/37283776
http://dx.doi.org/10.17161/kjm.vol16.19524
_version_ 1785053937287561216
author Emerson, Amanda K.
Hughes, Dorothy
author_facet Emerson, Amanda K.
Hughes, Dorothy
author_sort Emerson, Amanda K.
collection PubMed
description INTRODUCTION: The purpose of this study was to determine referral initiation and completion disparities across primary care encounters at the Hope Family Care Center (HFCC) in Kansas City, MO, by payor type (primary insurance): private insurance, Medicaid, Medicare, and self-pay. METHODS: Data were collected and analyzed for all encounters (N = 4,235) over a 15-month period, including payor type, referral initiation and completion, and demographics. Referral initiation and completion were calculated by payor type and differences analyzed using Chi-square tests and t-tests. Logistic regression examined payor type association with referral initiation and completion, accounting for demographic variables. RESULTS: Our analysis showed a meaningful difference in rate of referral to specialists by payor type. The Medicaid encounter referral initiation rate was higher than rates for all other payor types (7.4% vs. 5.0%), and self-pay encounters’ referral initiation rate was lower than rates for all other payor types (3.8% vs. 6.4%). Using logistic regression, Medicaid encounters had 1.4 greater odds, and self-pay encounters 0.7 greater odds, of initiating a referral compared to private insurance encounters. There was no difference in referral completion by payor type or demographic category. CONCLUSIONS: Equal referral completion rates across payor types suggested HFCC may have had well-established referral resources for patients. Higher referral initiation rates for Medicaid and lower for self-pay may suggest that insurance coverage offered financial confidence when seeking specialist care. Higher odds of Medicaid encounters initiating a referral could imply greater health needs among Medicaid patients.
format Online
Article
Text
id pubmed-10241200
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher University of Kansas Medical Center
record_format MEDLINE/PubMed
spelling pubmed-102412002023-06-06 Disparities in Referral Initiation and Completion at an Urban FQHC Look-alike (FQHC-LA) Clinic Emerson, Amanda K. Hughes, Dorothy Kans J Med Original Research INTRODUCTION: The purpose of this study was to determine referral initiation and completion disparities across primary care encounters at the Hope Family Care Center (HFCC) in Kansas City, MO, by payor type (primary insurance): private insurance, Medicaid, Medicare, and self-pay. METHODS: Data were collected and analyzed for all encounters (N = 4,235) over a 15-month period, including payor type, referral initiation and completion, and demographics. Referral initiation and completion were calculated by payor type and differences analyzed using Chi-square tests and t-tests. Logistic regression examined payor type association with referral initiation and completion, accounting for demographic variables. RESULTS: Our analysis showed a meaningful difference in rate of referral to specialists by payor type. The Medicaid encounter referral initiation rate was higher than rates for all other payor types (7.4% vs. 5.0%), and self-pay encounters’ referral initiation rate was lower than rates for all other payor types (3.8% vs. 6.4%). Using logistic regression, Medicaid encounters had 1.4 greater odds, and self-pay encounters 0.7 greater odds, of initiating a referral compared to private insurance encounters. There was no difference in referral completion by payor type or demographic category. CONCLUSIONS: Equal referral completion rates across payor types suggested HFCC may have had well-established referral resources for patients. Higher referral initiation rates for Medicaid and lower for self-pay may suggest that insurance coverage offered financial confidence when seeking specialist care. Higher odds of Medicaid encounters initiating a referral could imply greater health needs among Medicaid patients. University of Kansas Medical Center 2023-05-25 /pmc/articles/PMC10241200/ /pubmed/37283776 http://dx.doi.org/10.17161/kjm.vol16.19524 Text en © 2023 The University of Kansas Medical Center https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Research
Emerson, Amanda K.
Hughes, Dorothy
Disparities in Referral Initiation and Completion at an Urban FQHC Look-alike (FQHC-LA) Clinic
title Disparities in Referral Initiation and Completion at an Urban FQHC Look-alike (FQHC-LA) Clinic
title_full Disparities in Referral Initiation and Completion at an Urban FQHC Look-alike (FQHC-LA) Clinic
title_fullStr Disparities in Referral Initiation and Completion at an Urban FQHC Look-alike (FQHC-LA) Clinic
title_full_unstemmed Disparities in Referral Initiation and Completion at an Urban FQHC Look-alike (FQHC-LA) Clinic
title_short Disparities in Referral Initiation and Completion at an Urban FQHC Look-alike (FQHC-LA) Clinic
title_sort disparities in referral initiation and completion at an urban fqhc look-alike (fqhc-la) clinic
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241200/
https://www.ncbi.nlm.nih.gov/pubmed/37283776
http://dx.doi.org/10.17161/kjm.vol16.19524
work_keys_str_mv AT emersonamandak disparitiesinreferralinitiationandcompletionatanurbanfqhclookalikefqhclaclinic
AT hughesdorothy disparitiesinreferralinitiationandcompletionatanurbanfqhclookalikefqhclaclinic