Expanding federal funding to community health centers slows decline in access for low-income adults.

OBJECTIVE: To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. DATA SOURCES: Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000-2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001-2008). STUDY
DESIGN: We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. DATA COLLECTION: We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. PRINCIPAL
FINDINGS: Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults.
CONCLUSIONS: Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. © Health Research and Educational Trust.