South Los Angeles relies primarily on community health clinics for its health care, and a new study indicates that's a good thing.
That's because it found that government-funded community health centers, the vast majority of whose patients are low-income or uninsured, provide care that is as good as or better than the care patients receive at private practices.
Researchers looked at more than 73,000 records of visits to private practices and community clinics and looked at how physicians adhered to both professional and federal guidelines for 18 quality-of-care measures. For 13 of those 18 measures, community clinic physicians performed just as well as their private practice counterparts.
On the remaining five measures, clinic physicians did a better job of following guidelines.
That's good news for those charged with implementing the provisions of the Affordable Care Act; as health care coverage expands, that intensifies the challenge of increasing capacity. Community health clinics will take on a large chunk of the new patient population, providing care to more folks who were previously uninsured.
Nina Vaccaro is the executive director of the Southside Coalition of Community Health Clinics, a group of eight clinics that serves South L.A. which includes UMMA Community Clinic, St. John's Well Child and Family Center and South Central Family Health Center. She said she was "very pleased" with the findings.
"It validates just how high the quality of services are at community clinics, and that it really is a stereotype that a community clinic is the place of last resort because you're going to get the worst care and customer service from the doctors and staff there," she said.
Vaccaro said she'd wondered for a long time how clinics stack up against private health care providers, especially considering some of the unique challenges clinics face.
"We know for a fact that community clinics are providing care with some constraints with the resources we do have," she explained. "But you've got physicians that are so dedicated to this community – they're not there for the paycheck. And because they care about their patients, they find a way to provide the care their patients need with the resources they have."
Dr. Randall Stafford, the study's senior author, echoed that in a statement. "These are centers where physicians are not as profit-driven and many have incentives more in line with providing quality care," he said.
That kind of mindset fosters a spirit of innovation, Vacarro said, which is particularly crucial because clinics also tend to work with populations that are much more sick.
As far as the broader response to the study's findings, Vaccaro is hopeful that the findings will encourage more investment in community clinics.
"It speaks to the return on the investment when you invest funding into a community clinic," she said. "You're producing quality care at affordable costs to the community."
If Vaccaro had her way, medical care wouldn't be a for-profit field. The study indicates a promising future for community health clinics, but not the one she wants.
"I would like to think the model of community-based health care that's non-profit and driven from a grassroots perspective is a model for the future," she said. "But I'm not too optimistic about that being the case."
The 18 quality-of-care measures the study looked at are listed below; the ones marked with an asterisk are the ones in which community clinics performed better:
1. Antithrombotic use in atrial fibrillation
2. ACE inhibitor use in congestive heart failure*
3. Aspirin use in CAD
4. Beta-blocker use in CAD*
5. Statin use in CAD
6. Inhaled corticosteroids in asthma in adults*
7. Inhaled corticosteroids in asthma in children
8. Depression treatment
9. No use of benzodiazephines in depression
10. Smoking-cessation counseling
11. Diet counseling in at-risk adults
12. Exercise counseling in at-risk adults
13. Diet counseling in at-risk adolescents
14. Exercise counseling in at-risk adolescents
15. Blood pressure screening*
16. No screening EKG in low-risk patients*
17. No screening urinalysis in low-risk patients
18. Appropriate medications in elderly
You can read the full study here.