Operational efficiency, patient composition and regional context of U.S. health centers: Associations with access to early prenatal care and low birth weight

dc.contributor.authorThorsen, Maggie L.
dc.contributor.authorThorsen, Andreas H.
dc.contributor.authorMcGarvey, Ronald G.
dc.date.accessioned2019-05-15T17:15:40Z
dc.date.available2019-05-15T17:15:40Z
dc.date.issued2019-04
dc.description.abstractCommunity health centers (CHCs) provide comprehensive medical services to medically under-served Americans, helping to reduce health disparities. This study aimed to identify the unique compositions and contexts of CHCs to better understand variation in access to early prenatal care and rates of low birth weights (LBW). Data include CHC-level data from the Uniform Data System, and regional-level data from the US Census American Community Survey and Behavioral Risk Factor Surveillance System. First, latent class analysis was conducted to identify unobserved subgroups of CHCs. Second, data envelopment analysis was performed to evaluate the operational efficiency of CHCs. Third, we used generalized linear models to examine the associations between the CHC subgroups, efficiency, and perinatal outcomes. Seven classes of CHCs were identified, including two rural classes, one suburban, one with large centers serving poor minorities in low poverty areas, and three urban classes. Many of these classes were characterized by the racial compositions of their patients. Findings indicate that CHCs serving white patients in rural areas have greater access to early prenatal care. Health centers with greater efficiency have lower rates of LBW, as do those who serve largely white patient populations in rural areas. CHCs serving poor racial minorities living in low-poverty areas had particularly low levels of access to early prenatal care and high rates of LBW. Findings highlight that significant diversity exists in the sociodemographic composition and regional context of US health centers, in ways that are associated with their operations, delivery of care, and health outcomes. Results from this study highlight that while the provision of early prenatal care and the efficiency with which a health center operates may improve the health of the women served by CHCs and their babies, the underlying social and economic conditions facing patients ultimately have a larger association with their health.en_US
dc.description.sponsorshipNational Institute of General Medical Sciences Award Number 5P20GM104417en_US
dc.identifier.citationThorsen, Maggie L., Andreas H. Thorsen, and Ronald G. McGarvey. "Operational efficiency, patient composition and regional context of U.S. health centers: Associations with access to early prenatal care and low birth weight." Social Science & Medicine 226 (April 2019): 143-152. DOI:10.1016/j.socscimed.2019.02.043.en_US
dc.identifier.issn1873-5347
dc.identifier.urihttps://scholarworks.montana.edu/handle/1/15475
dc.rightsThis Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).en_US
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en_US
dc.titleOperational efficiency, patient composition and regional context of U.S. health centers: Associations with access to early prenatal care and low birth weighten_US
dc.typeArticleen_US
mus.citation.extentfirstpage155en_US
mus.citation.extentlastpage162en_US
mus.citation.journaltitleSocial Science & Medicineen_US
mus.citation.volume226en_US
mus.contributor.orcidThorsen, Andreas H.|0000-0002-4592-4413en_US
mus.contributor.orcidThorsen, Maggie L.|0000-0003-3298-5409en_US
mus.data.thumbpage1
mus.identifier.categoryBusiness, Economics & Managementen_US
mus.identifier.categorySocial Sciencesen_US
mus.identifier.doi10.1016/j.socscimed.2019.02.043en_US
mus.relation.collegeCollege of Businessen_US
mus.relation.departmentBusiness.en_US
mus.relation.universityMontana State University - Bozemanen_US

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