Private Safety-Net Clinics: Effects of Financial Pressures and Community Characteristics on Closures / Suhui Li, Avi Dor, Jesse M. Pines, Mark S. Zocchi, Renee Y. Hsia.

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Li, Suhui

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Material type: Text

TextSeries: Working Paper Series (National Bureau of Economic Research) ; no. w21648.Publication details: Cambridge, Mass. National Bureau of Economic Research 2015.Description: 1 online resource: illustrations (black and white)Subject(s):

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Abstract: In order to better understand what threatens vulnerable populations' access to primary care, it is important to understand the factors associated with closing safety-net clinics. This paper examines how a clinic's financial position, productivity, and community characteristics are associated with its risk of closure. We examine patterns of closures among private-run primary care clinics (PCCs) in California between 2006 and 2012. We use a discrete-time proportional hazard model to assess relative hazard ratios of covariates, and a random-effect hazard model to adjust for unobserved heterogeneity among PCCs. We find that lower net income from patient care, smaller amount of government grants, and lower productivity were associated with significantly higher risk of PCC closure. We also find that federally qualified health centers (FQHCs) and non-FQHCs generally faced the same risk factors of closure. These results underscore the critical role of financial incentives in the long-term viability of safety-net clinics.

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Item type	Home library	Collection	Call number	Status	Date due	Barcode	Item holds
Working Paper	Biblioteca Digital	Colección NBER	nber w21648 (Browse shelf(Opens below))	Not For Loan

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October 2015.

In order to better understand what threatens vulnerable populations' access to primary care, it is important to understand the factors associated with closing safety-net clinics. This paper examines how a clinic's financial position, productivity, and community characteristics are associated with its risk of closure. We examine patterns of closures among private-run primary care clinics (PCCs) in California between 2006 and 2012. We use a discrete-time proportional hazard model to assess relative hazard ratios of covariates, and a random-effect hazard model to adjust for unobserved heterogeneity among PCCs. We find that lower net income from patient care, smaller amount of government grants, and lower productivity were associated with significantly higher risk of PCC closure. We also find that federally qualified health centers (FQHCs) and non-FQHCs generally faced the same risk factors of closure. These results underscore the critical role of financial incentives in the long-term viability of safety-net clinics.