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Research Shows How Health Centers Stack Up Against Private Practices

By Micah Clemens

Community Health Centers demonstrated equal or better quality performance than private practices on ambulatory quality measures, despite serving patients with more chronic disease and socieoeconomic complexity.  That’s the conclusion of a new study by the Stanford University School of Medicine and the University of California-San Francisco, which focused on how Community Health Centers stack up with patient care against private practices.  This is the first national study to compare ambulatory performance in chronic disease versus private practice offices.

The results show that health center physicians adhered to professional and federal guidelines better in five of 18 measures as compared with their private practice colleagues, and performed just as well in the other 13 areas.

“If Community Health Centers are going to be taking up some of the new demand, we can be confident that they’re giving relatively good care,”  said Randall Stafford, MD, professor of medicine at the Stanford Prevention Research Center,  in a Stanford University press release. “These are centerd where physcians are not as profit-driven and many have incentives more in line with providing quality care.”

Stafford and his colleagues analyzed records of 73,074 visits to private practices, FQHCs and FQHC Look-Alikes. They evaluated the physicians’ adherence to professional and federal guidelines for 18 measures, which included treatments for specific diseases, screening for certain conditions, and diet and lifestyle counseling.

“We looked at fairly common conditions that are seen in primary care,” said lead author L. Elizabeth Goldman, MD, of the University of California, San Francisco. The researchers found that Community Health Center physicians performed as well as their private practice colleagues in 13 of the 18 measures. For the remaining five measures — use of ACE inhibitors for congestive heart failure, use of beta blockers, use of inhaled corticosteroids for adult asthmatics, blood pressure screening and avoidance of electrocardiograms in low-risk patients — the community physicians followed recommendations a higher percent of the time.

The study is published in the American Journal of Preventive Medicine.