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The Effects of Community Health Center Care on Medical Expenditures for Children and Adults

Propensity Score Analyses

Bruen, Brian K., MS; Ku, Leighton, PhD, MPH

The Journal of Ambulatory Care Management: April/June 2019 - Volume 42 - Issue 2 - p 128–137
doi: 10.1097/JAC.0000000000000263
Original Articles

This study examines whether community health center (CHC) patients have lower medical expenditures. Using 2011-2012 Medical Expenditure Panel Survey data, propensity score methods are used to compare annual expenditures for adults and children receiving at least half their ambulatory care at CHCs versus those who did not. For children, CHC use was associated with 35.3% lower total medical expenditures ($627), 40.0% lower ambulatory expenditures ($279), and 49.1% lower prescription drug expenditures ($157) (all Ps < .05). For adults, the reduction in hospital expenditures for CHC users ($529) was statistically significant at a P < .10 threshold. Estimated differences in total expenditures and other expenditure categories were not statistically significant for adults.

Department of Health Policy and Management, Milken Institute School of Public Health, Washington, District of Columbia.

Correspondence: Brian K. Bruen, MS, Department of Health Policy and Management, Milken Institute School of Public Health, 950 New Hampshire Ave, NW, 6th Floor, Washington, DC 20052 (

This project was supported by the Geiger Gibson/RCHN Community Health Research Collaborative, with partial support from the National Association of Community Health Centers.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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