Methodological challenges of measuring primary care delivery to pediatric medicaid beneficiaries who use community health centers

Am J Public Health. 2013 Feb;103(2):273-5. doi: 10.2105/AJPH.2012.300884. Epub 2012 Dec 13.


Efforts to measure quality of care have focused on ambulatory care providers. We examined the performance of community health centers serving children on Medicaid in 3 states. Descriptive analysis showed considerable patient population heterogeneity, and regression analysis demonstrated that variation explained by the assigned provider was small (mean R(2) = 4.3%) compared with the variation explained by patient demographic variables (mean R(2) = 29.9%). The results reinforce the need for caution when one is attributing quality differences to provider performance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Community Health Centers / statistics & numerical data*
  • Delivery of Health Care / statistics & numerical data*
  • Health Services Needs and Demand
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Medicaid / statistics & numerical data*
  • Pediatrics
  • Primary Health Care / statistics & numerical data*
  • Regression Analysis
  • United States