National Use of Safety-Net Clinics for Primary Care among Adults with Non-Medicaid Insurance in the United States

To describe the prevalence, characteristics, and predictors of safety-net use for primary care among non-Medicaid insured adults (i.e., those with private insurance or Medicare). Cross-sectional analysis using the 2006-2010 National Ambulatory Medical Care Surveys, annual probability samples of outp...

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Bibliographic Details
Published in:PloS one 2016-03, Vol.11 (3), p.e0151610-e0151610
Main Authors: Nguyen, Oanh Kieu, Makam, Anil N, Halm, Ethan A
Format: Article
Language:English
Subjects:
Adult
Adults
Analysis
Bivariate analysis
Care and treatment
Chronic conditions
Chronic diseases
Chronic illnesses
Diabetes mellitus
Earth Sciences
Engineering and Technology
Female
Government programs
Health care
Health care policy
Health insurance
Humans
Hypertension
Indigent care
Insurance
Insurance coverage
Low income groups
Male
Management
Medicaid
Medicare
Medicine and Health Sciences
Methods
Minority Groups
People and Places
Polls & surveys
Poverty
Primary care nursing
Primary Health Care
Regression analysis
Safety
Safety and security measures
Safety-net Providers
Social Sciences
Statistical analysis
United States
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Summary:To describe the prevalence, characteristics, and predictors of safety-net use for primary care among non-Medicaid insured adults (i.e., those with private insurance or Medicare). Cross-sectional analysis using the 2006-2010 National Ambulatory Medical Care Surveys, annual probability samples of outpatient visits in the U.S. We estimated national prevalence of safety-net visits using weighted percentages to account for the complex survey design. We conducted bivariate and multivariate logistic regression analyses to examine characteristics associated with safety-net clinic use. More than one-third (35.0%) of all primary care safety-net clinic visits were among adults with non-Medicaid primary insurance, representing 6,642,000 annual visits nationally. The strongest predictors of safety-net use among non-Medicaid insured adults were: being from a high-poverty neighborhood (AOR 9.53, 95% CI 4.65-19.53), being dually eligible for Medicare and Medicaid (AOR 2.13, 95% CI 1.38-3.30), and being black (AOR 1.97, 95% CI 1.06-3.66) or Hispanic (AOR 2.28, 95% CI 1.32-3.93). Compared to non-safety-net users, non-Medicaid insured adults who used safety-net clinics had a higher prevalence of diabetes (23.5% vs. 15.0%, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0151610