Open AccessMethodological Challenges of Measuring Primary Care Delivery to Pediatric Medicaid Beneficiaries Who Use Community Health Centers
Author(s) -
Karen R. Tyo,
Deborah Gurewich,
Donald S. Shepard
Publication year - 2013
Publication title -
american journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.284
H-Index - 264
eISSN - 1541-0048
pISSN - 0090-0036
DOI - 10.2105/ajph.2012.300884
Subject(s) - medicaid , descriptive statistics , medicine , primary care , family medicine , population , health care , ambulatory , quality (philosophy) , ambulatory care , regression analysis , environmental health , statistics , philosophy , mathematics , epistemology , economics , economic growth
Efforts to measure quality of care have focused on ambulatory care providers. We examined the performance of community health centers serving children on Medicaid in 3 states. Descriptive analysis showed considerable patient population heterogeneity, and regression analysis demonstrated that variation explained by the assigned provider was small (mean R(2) = 4.3%) compared with the variation explained by patient demographic variables (mean R(2) = 29.9%). The results reinforce the need for caution when one is attributing quality differences to provider performance.