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Health Affairs Studies Examine Hospital-Physician Portals and Community Health Center Impact on Racial/Ethnic Disparities in Care Access
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Hospital-Physician Portals: The Role of Competition in Driving Clinical Data Exchange by Joy M. Grossman, Ph.D, HSC senior researcher; Thomas S. Bodenheimer, M.D., HSC senior consulting researcher; and Kelly McKenzie, HSC health research analyst
Recent policy efforts to encourage the use of health information technology are emphasizing development of community-wide health information exchanges to share clinical data across patient care settings. Based on findings from HSCs 2005 site visits to 12 nationally representative communities, the study found that most large hospitals have or are developing physician portals to provide admitting physicians with remote access to patient records, but there is little data sharing among unaffiliated organizations. Competition among hospitals for physicians is a key factor driving adoption of these proprietary systems. In contrast, provider and health plan competition and adversarial relationships between providers and plans are viewed as major barriers to community-wide clinical data sharing.
The 12 nationally representative communities are Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y. HSC has been tracking changes in these markets for the past 10 years.
Would Safety-Net Expansions Offset Reduced Access Resulting from Lost Insurance Coverage? Race/Ethnicity Differences by Jack Hadley, Ph.D., HSC senior fellow and principal research associate at the Urban Institute; Peter Cunningham, Ph.D, HSC senior fellow; and J. Lee Hargraves, research associate professor at the University of Massachusetts Medical School in Worcester
This study simulated whether increased community health center (CHC) funding
under the Bush administration narrowed racial/ethnic gaps in access to care
among low-income people. Expanded CHC funding resulted in small increases in
access to care, more so for minorities than for whites. Spanish-speaking Hispanics
had the largest improvements in access in the simulation. However, minorities
experienced bigger drops in insurance coverage. The net result was no improvements
in the access measures for Spanish-speaking Hispanics and slight decreases in
access for whites, English-speaking Hispanics and African Americans. Access
gaps either remained the same or worsened slightly for English-speaking Hispanics
and African Americans relative to whites.
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.