Objective: To demonstrate use of the electronic health record (EHR) for health insurance surveillance and identify factors associated with lack of coverage.
Materials And Methods: Using EHR data, we conducted a retrospective, longitudinal cohort study of adult patients (n = 279 654) within a national network of community health centers during a 2-year period (2012-2013).
Results: Factors associated with higher odds of being uninsured (vs Medicaid-insured) included: male gender, age >25 years, Hispanic ethnicity, income above the federal poverty level, and rural residence (P < .01 for all). Among patients with no insurance at their initial visit (n = 114 000), 50% remained uninsured for every subsequent visit.
Discussion: During the 2 years prior to 2014, many patients utilizing community health centers were unable to maintain stable health insurance coverage.
Conclusion: As patients gain access to health insurance under the Affordable Care Act, the EHR provides a novel approach to help track coverage and support vulnerable patients in gaining and maintaining coverage.
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| http://dx.doi.org/10.1093/jamia/ocv179 | DOI Listing |
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