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The impact of contract primary care on health care expenditures and quality of care.

Publication ,  Journal Article
Liu, C-F; Chapko, MK; Perkins, MW; Fortney, J; Maciejewski, ML
Published in: Med Care Res Rev
June 2008

The Department of Veterans Affairs (VA) established community-based outpatient clinics to improve veterans' access to primary care. This article compares VA use and expenditures among primary care users at 76 VA-staffed community clinics (n = 17,060) and 32 non-VA contract community clinics receiving capitation (n = 6,842) using VA administrative databases. It estimates utilization using negative binomial models and expenditures using generalized linear one-part or two-part models. Contract community clinic patients are less likely to use all types of outpatient services than VA-staffed community clinic patients but had similar quality of care. For patients seeking care, contract community clinic patients had similar specialty care expenditures but lower primary care, outpatient, and overall expenditures. Results suggest that capitated contract clinics did not shift costs to specialty care and appeared to be an economically efficient mechanism for improving veterans' access to primary care while meeting VA quality of care standards.

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Published In

Med Care Res Rev

DOI

ISSN

1077-5587

Publication Date

June 2008

Volume

65

Issue

3

Start / End Page

300 / 314

Location

United States

Related Subject Headings

  • Utilization Review
  • United States Department of Veterans Affairs
  • United States
  • Quality of Health Care
  • Primary Health Care
  • Middle Aged
  • Male
  • Humans
  • Hospitals, Veterans
  • Health Services Accessibility
 

Citation

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Liu, C.-F., Chapko, M. K., Perkins, M. W., Fortney, J., & Maciejewski, M. L. (2008). The impact of contract primary care on health care expenditures and quality of care. Med Care Res Rev, 65(3), 300–314. https://doi.org/10.1177/1077558707313034
Liu, Chuan-Fen, Michael K. Chapko, Mark W. Perkins, John Fortney, and Matthew L. Maciejewski. “The impact of contract primary care on health care expenditures and quality of care.Med Care Res Rev 65, no. 3 (June 2008): 300–314. https://doi.org/10.1177/1077558707313034.
Liu C-F, Chapko MK, Perkins MW, Fortney J, Maciejewski ML. The impact of contract primary care on health care expenditures and quality of care. Med Care Res Rev. 2008 Jun;65(3):300–14.
Liu, Chuan-Fen, et al. “The impact of contract primary care on health care expenditures and quality of care.Med Care Res Rev, vol. 65, no. 3, June 2008, pp. 300–14. Pubmed, doi:10.1177/1077558707313034.
Liu C-F, Chapko MK, Perkins MW, Fortney J, Maciejewski ML. The impact of contract primary care on health care expenditures and quality of care. Med Care Res Rev. 2008 Jun;65(3):300–314.
Journal cover image

Published In

Med Care Res Rev

DOI

ISSN

1077-5587

Publication Date

June 2008

Volume

65

Issue

3

Start / End Page

300 / 314

Location

United States

Related Subject Headings

  • Utilization Review
  • United States Department of Veterans Affairs
  • United States
  • Quality of Health Care
  • Primary Health Care
  • Middle Aged
  • Male
  • Humans
  • Hospitals, Veterans
  • Health Services Accessibility