Evidence map›Paper›PMID 33090467›Full record

ArticleHealth services research2021

Optimal staffing in community health centers to improve quality of care.

Qian Luo, Avi Dor, Patricia Pittman

Open access · greenAbstract read
In one paragraph

Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Qian LuoThe Fitzhugh Mullan Institute for Health Workforce Equity, Milken Institute School of Public Health, Department of Health Policy and Management, The George Washington University, Washington, District of Columbia, USA.ORCID 0000-0002-3413-9727
Avi DorMilken Institute School of Public Health, Department of Health Policy and Management, The George Washington University, Washington, District of Columbia, USA.ORCID 0000-0003-4475-4333
Patricia PittmanThe Fitzhugh Mullan Institute for Health Workforce Equity, Milken Institute School of Public Health, Department of Health Policy and Management, The George Washington University, Washington, District of Columbia, USA.
Milken Institute · US

Funding

Costs and Quality of Primary Care Services: Implications for Community Health CentersR01HS026816 · AHRQ · GEORGE WASHINGTON UNIVERSITY · PI DOR, AVI · 2019 to 2022
$1.1M
AHRQ HHS R01 HS026816HRSA HHS U81HP26495-01-00
6 · The paper itself

Abstract

objectiveTo explore optimal workforce configurations in the production of care quality in community health centers (CHCs), accounting for interactions among occupational categories, as well as contributions to the volume of services. DATA SOURCES: We linked the Uniform Data System from 2014 to 2016 with Internal Revenue Service nonprofit tax return data. The final database contained 3139 center-year observations from 1178 CHCs. STUDY

designWe estimated a system of two generalized linear production functions, with quality of care and volume of services as outputs, using the average percent of diabetic patients with controlled A1C level and hypertensive patients with controlled blood pressure as quality measures. To explore the substitutability and complementarity between staffing categories, we estimated a revenue function.

findingsPrimary care physicians and advanced practice clinicians achieve similar quality outcomes (3.2 percent and 3.0 percent improvement in chronic condition management per full-time equivalent (FTE), respectively). Advanced practice clinicians generate less revenue per FTE but are generally less costly to employ.

conclusionAs quality incentives are further integrated into payment systems, CHCs will need to optimize their workforce configuration to improve quality. Given the relative efficiency of advanced practice clinicians in producing quality, further hiring of these professionals is a cost-effective investment for CHCs.

Indexed as

Community Health CentersHumansPersonnel TurnoverPhysicians, Primary CareQuality of Health CareReimbursement MechanismsWorkforcecommunity health centersproduction functionquality of careworkforce

Identifiers

PMID33090467
PMCPMC7839644
OpenAlexW3092368439

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.