The Use of Community Health Workers in Community Health Centers.
Med Care
; 59(Suppl 5): S457-S462, 2021 10 01.
Article
in En
| MEDLINE
| ID: mdl-34524243
ABSTRACT
BACKGROUND:
Until 2016, community health centers (CHCs) reported community health workers (CHWs) as part of their overall enabling services workforce, making analyses of CHW use over time infeasible in the annual Uniform Data System (UDS).OBJECTIVE:
The objective of this study was to examine changes in the CHW workforce among CHCs from 2016 to 2018 and factors associated with the use of CHWs. RESEARCH DESIGN, SUBJECTS,MEASURES:
The two-part model estimated separate effects for the probability of using any CHW and extent of CHW full-time equivalents (FTEs) reported in those CHCs, using a total of 4102 CHC-year observations from 2016 to 2018. To estimate the extent to which increases in CHW workforce are attributable to real growth or rather are a consequence of a change in reporting category, we also conducted a difference-in-differences analysis to compare non-CHW enabling services FTEs between CHCs with and without CHWs before (2013-2015) and after (2016-2018) the reporting change in 2016.RESULTS:
The rate of CHCs that employed CHWs rose from 20.04% in 2016 to 28.34% in 2018, while average FTEs stayed relatively flat (3.32 FTEs). Patient visit volume (larger CHCs) and grant funding (less reliant on federal but more reliant on private funding) were significant factors associated with CHW use. However, we found that a substantial portion of this growth was attributable to a change in UDS reporting categories.CONCLUSION:
While we do not address the reasons why CHCs have been slow to use CHWs, our results point to substantial financial barriers associated with CHCs' expanding the use of CHWs.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Community Health Workers
/
Community Health Centers
/
Community Health Services
/
Health Workforce
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
Med Care
Year:
2021
Document type:
Article