NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH
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Jesse M. Pines

School of Medicine and Health Sciences
2030 M St, NW, 4th Floor
Washington, DC 20036

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Institutional Affiliation: George Washington University

NBER Working Papers and Publications

October 2015Private Safety-Net Clinics: Effects of Financial Pressures and Community Characteristics on Closures
with Suhui Li, Avi Dor, Mark S. Zocchi, Renee Y. Hsia: w21648
In order to better understand what threatens vulnerable populations’ access to primary care, it is important to understand the factors associated with closing safety-net clinics. This paper examines how a clinic’s financial position, productivity, and community characteristics are associated with its risk of closure. We examine patterns of closures among private-run primary care clinics (PCCs) in California between 2006 and 2012. We use a discrete-time proportional hazard model to assess relative hazard ratios of covariates, and a random-effect hazard model to adjust for unobserved heterogeneity among PCCs. We find that lower net income from patient care, smaller amount of government grants, and lower productivity were associated with significantly higher risk of PCC closure. We also find ...
 
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