Radiology Utilization in an Academic Center Partnership With a Federally Qualified Health Center: A Cross-Sectional Study.

Abstract

Objective: Federally qualified health centers (FQHCs) serve medically underserved populations. In 2013, UW Health, the health system of the University of Wisconsin, partnered with Access Community Health Centers (ACHC), the FQHC network in Madison, Wisconsin, to provide on-site outpatient imaging. This study characterized radiography utilization associated with the UW Health-ACHC partnership compared with other UW Health outpatient imaging sites.

Methods: We included health record data from January 2013 to December 2022 on all outpatient radiographs completed at UW Health sites. We compared characteristics between patients ever seen at ACHC clinics with patients seen only at non-ACHC UW Health clinics using χ² and t tests. Logistic regression was used to assess factors associated with imaging utilization at ACHC.

Results: Over the study period, 4% (23,794 of 650,685) of imaging encounters occurred at ACHC and 4% (10,986 of 246,104) of patients used ACHC facilities at least once. ACHC clinic patients were younger (41 versus 42) and more often female (55% versus 53%), Black or African American (22% versus 5%), Hispanic or Latino (34% versus 4%), with Medicaid (33% versus 9%), uninsured (18% versus 4%), and living in metropolitan areas (98% versus 88%) with higher Social Deprivation Index scores (53 versus 31) (P < .001). In multivariable analyses, patients from racial or ethnic minority groups, without commercial insurance, residing in a metropolitan area, and with a non-English primary language were more likely to ever use ACHC radiography services (P < .001).

Discussion: FQHCs represent trusted, community health centers serving medically underserved populations. Partnerships between academic institutions and FQHCs can increase geographic imaging access among these groups.