Brigit Hatch1, Carrie Tillotson2, Heather Angier2, Miguel Marino2, Megan Hoopes3, Nathalie Huguet2, Jennifer DeVoe4. 1. Department of Family Medicine, Oregon Health & Science University, Portland Oregon, USA adamusb@ohsu.edu. 2. Department of Family Medicine, Oregon Health & Science University, Portland Oregon, USA. 3. OCHIN, Inc, Research Division, Portland, Oregon, USA. 4. Department of Family Medicine, Oregon Health & Science University, Portland Oregon, USA OCHIN, Inc, Research Division, Portland, Oregon, USA.
Abstract
OBJECTIVE: To demonstrate use of the electronic health record (EHR) for health insurance surveillance and identify factors associated with lack of coverage. MATERIALS AND METHODS: Using EHR data, we conducted a retrospective, longitudinal cohort study of adult patients (n = 279 654) within a national network of community health centers during a 2-year period (2012-2013). RESULTS: Factors associated with higher odds of being uninsured (vs Medicaid-insured) included: male gender, age >25 years, Hispanic ethnicity, income above the federal poverty level, and rural residence (P < .01 for all). Among patients with no insurance at their initial visit (n = 114 000), 50% remained uninsured for every subsequent visit. DISCUSSION: During the 2 years prior to 2014, many patients utilizing community health centers were unable to maintain stable health insurance coverage. CONCLUSION: As patients gain access to health insurance under the Affordable Care Act, the EHR provides a novel approach to help track coverage and support vulnerable patients in gaining and maintaining coverage.
OBJECTIVE: To demonstrate use of the electronic health record (EHR) for health insurance surveillance and identify factors associated with lack of coverage. MATERIALS AND METHODS: Using EHR data, we conducted a retrospective, longitudinal cohort study of adult patients (n = 279 654) within a national network of community health centers during a 2-year period (2012-2013). RESULTS: Factors associated with higher odds of being uninsured (vs Medicaid-insured) included: male gender, age >25 years, Hispanic ethnicity, income above the federal poverty level, and rural residence (P < .01 for all). Among patients with no insurance at their initial visit (n = 114 000), 50% remained uninsured for every subsequent visit. DISCUSSION: During the 2 years prior to 2014, many patients utilizing community health centers were unable to maintain stable health insurance coverage. CONCLUSION: As patients gain access to health insurance under the Affordable Care Act, the EHR provides a novel approach to help track coverage and support vulnerable patients in gaining and maintaining coverage.
Keywords:
Patient Protection and Affordable Care Act; community health centers; electronic health records; health insurance; health services accessibility
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