ArticleMedical care2020
Using Electronic Health Records in Longitudinal Studies: Estimating Patient Attrition.
Article in Medical care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 52 citations in OpenAlex.
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- Association Between Nativity and Preventive Mammography Among Latina Community Health Center Patients.Journal of racial and ethnic health disparities · 2026Article
- Toward scalable early cancer detection: evaluating EHR-based predictive models against traditional screening criteria.NPJ precision oncology · 2026Article
- Predictive Model of Dynamic Subphenotypes for 30-Day Mortality in Emergency Department Patients with Suspected Infection Using the Vital Signs of the First 24 Hours: An Analytical Cohort Study in a Tertiary Care Clinic.Journal of clinical medicine · 2026Article
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- Transforming hypertension management with digital technology: a retrospective cohort study in four sub-Saharan African countries.BMJ public health · 2026Article
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- Enabling Drug-Induced Liver Injury Surveillance Through Automated Medication Extraction From Clinical Notes: A Medical Information Mart for Intensive Care IV Real-World Large Language Models Validation Study.Gastroenterology research · 2025Article
- Cervical Cancer Screening among Older Latina Migrant and Seasonal Farmworkers in a Network of Community Health Centers.Ethnicity & disease · 2025Observational
- TIMER: temporal instruction modeling and evaluation for longitudinal clinical records.NPJ digital medicine · 2025Article
- Comorbidities associated with a clinically-recognized delirium diagnosis in the hospital using real world data.Communications medicine · 2025Article
- Medicaid Eligibility Expansion Regardless of Immigration Status and Insurance Coverage Among Latinos Seen in Community Health Centers, 2018‒2023.American journal of public health · 2025Article
- Insurance Instability Among Community-Based Health Center Patients with Diabetes Post-Affordable Care Act Medicaid Expansion.Journal of the American Board of Family Medicine : JABFM · 2025Article
- Diabetes Complications Among Community-Based Health Center Patients with Varying Multimorbidity Patterns.Journal of general internal medicine · 2025Article
- Video versus audio telehealth in safety net clinic patients: Changes by rurality and time.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Association Between a Mother's Cervical Cancer Screening and Child's Human Papillomavirus (HPV) Vaccination Status.Maternal and child health journal · 2024Article
- Association of neighbourhood walkability and haemoglobin A1c levels among Latino and non-Hispanic White patients with diabetes.Family practice · 2024Article
- Observational
- Social Deprivation and Multimorbidity Among Community-Based Health Center Patients in the United States.Preventing chronic disease · 2024Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundElectronic health records (EHRs) provide rich data on many domains not routinely available in other data, as such, they are a promising source to study changes in health outcomes using longitudinal study designs (eg, cohort studies, natural experiments, etc.). Yet, patient attrition rates in these data are unknown.
objectiveThe objective of this study was to estimate overall and among adults with diabetes or hypertension: (1) patient attrition over a 3-year period at community health centers; and (2) the likelihood that patients with Medicaid permanently switched their source of primary care. RESEARCH
designA retrospective cohort study of 2012-2017 data from the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Data Research Network of community health centers were used to assess EHR data attrition. Oregon Medicaid enrollment and claims data were used to estimate the likelihood of changing the source of primary care. SUBJECTS: A total of 827,657 patients aged 19-64 with ≥1 ambulatory visit from 76 community health center systems across 20 states. In all, 232,891 Oregon Medicaid enrollees (aged 19-64) with a gap of ≥6 months following a claim for a visit billed to a primary care source. MEASURES: Percentage of patients not returning within 3 years of their qualifying visit (attrition). The probability that a patient with Medicaid permanently changed their primary care source.
resultsAttrition over the 3 years averaged 33.5%; attrition rates were lower (<25%) among patients with diabetes and/or hypertension. Among Medicaid enrollees, the percentage of provider change after a 6-month gap between visits was 12% for community health center patients compared with 39% for single-provider practice patients. Over 3 years, the likelihood of a patient changing to a new provider increased with length of time since their last visit but remained lowest among community health center patients.
conclusionThis study demonstrates the use of the EHR dataset is a reliable source of data to support longitudinal studies while highlighting variability in attrition by primary care source and chronic conditions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.