Enabling Services Improve Access To Care, Preventive Services, And Satisfaction Among Health Center Patients

Abstract

Enabling services address a combination of social determinants of health and barriers to access to primary care and are intended to reduce health disparities. They include care coordination; health education; transportation; and assistance with obtaining food, shelter, and benefits. Empirical evidence of enabling services' potential contribution to health outcomes is limited, which impedes their widespread dissemination. We examined how the receipt of enabling services influenced patient health care outcomes based on a nationally representative survey of patients served in 2014 at health centers funded by the Health Resources and Services Administration. We compared enabling services users and nonusers and found that enabling services were associated with 1.92 more health center visits, an 11.78-percentagepoint higher probability of getting a routine checkup, a 16.34-percentagepoint higher likelihood of having had a flu shot, and a 7.63-percentagepoint higher probability of patient satisfaction. Our results confirm the value of systematic delivery of enabling services in reducing access barriers and improving patient satisfaction.

Health Related Social Needs Among Chinese American Primary Care Patients During the COVID-19 Pandemic: Implications for Cancer Screening and Primary Care

“…Recent studies have shown a positive relationship between screening for and addressing HRSN and health care utilization, including cancer screening and treatment (82)(83)(84)(85). In addition, lower rate of colorectal cancer screen are observed in other educated AA populations elsewhere, which we did not observe in our study.…”

Influenza vaccination among U.S. pediatric patients receiving care from federally funded health centers

“…Given the demonstrated and potential efficacy of these factors in improving health care provided by health centers, HRSA has invested hundreds of millions of dollars to accelerate and optimize the adoption of health information technology, as well as incentivize the adoption of the patient-centered medical home model of care through its Quality Improvement Awards [30] . While previous studies have found positive effects of these innovations on access to care, quality of care, and disparities [26] , [32] , [33] , additional analyses may examine their potential impact specifically on pediatric influenza vaccine uptake.…”

“…Previous studies have identified several institutional factors which may contribute to health centers’ ability to provide equitable access to services across a broad range of clinical domains, such as cancer screening, chronic condition management, prenatal care, and well-visit check-ups. These institutional factors include the provision of supportive services (e.g., care coordination, health education, translation, transportation), early and widespread implementation of electronic health records, and recognition as patient-centered medical homes [26] , [32] , [33] . Strengthening access to and quality of primary care broadly through these efforts may translate to increased use of specific services including influenza vaccinations, and fewer missed opportunities for influenza vaccinations.…”

“…Strengthening access to and quality of primary care broadly through these efforts may translate to increased use of specific services including influenza vaccinations, and fewer missed opportunities for influenza vaccinations. Indeed, Yue and colleagues (2019) found that adult health center patients who used support services had a 16 percentage point higher likelihood of receiving an influenza vaccine compared with those who did not use support services [32] . Given the demonstrated and potential efficacy of these factors in improving health care provided by health centers, HRSA has invested hundreds of millions of dollars to accelerate and optimize the adoption of health information technology, as well as incentivize the adoption of the patient-centered medical home model of care through its Quality Improvement Awards [30] .…”

Comparing Rates of Multiple Chronic Conditions at Primary Care and Mental Health Visits to Community Health Centers Versus Private Practice Providers

“…Federal statute governing the Health Center Program requires that CHCs offer a comprehensive set of services beyond primary care, such as behavioral, oral, pharmacy, and “enabling” services that facilitate access to and better use of health care services (examples of these “enabling” services often include transportation, case management, health education, and translation). Recent research demonstrates that enabling services help patients navigate the health care system and achieve greater access to needed care ( Yue et al, 2019 ) and may even lead to improved health outcomes, although more research is needed on specific patient outcomes.…”