Journal Article

Using the electronic health record for assessment of health insurance in community health centers

Brigit Hatch, Carrie Tillotson, Heather Angier, Miguel Marino, Megan Hoopes, Nathalie Huguet and Jennifer DeVoe

in Journal of the American Medical Informatics Association

Published on behalf of American Medical Informatics Association

Volume 23, issue 5, pages 984-990
Published in print September 2016 | ISSN: 1067-5027
Published online January 2016 | e-ISSN: 1527-974X | DOI: https://dx.doi.org/10.1093/jamia/ocv179
Using the electronic health record for assessment of health insurance in community health centers

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  • Medical Statistics and Methodology
  • Bioinformatics and Computational Biology
  • Biomathematics and Statistics

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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: electronic health records; health insurance; community health centers; health services accessibility; Patient Protection and Affordable Care Act

Journal Article.  3755 words.  Illustrated.

Subjects: Medical Statistics and Methodology ; Bioinformatics and Computational Biology ; Biomathematics and Statistics

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