• John Heintzman, Miguel Marino, Megan Hoopes, Steffani Bailey, Rachel Gold, Courtney Crawford, Stuart Cowburn, Jean O'Malley, Christine Nelson, and Jennifer E DeVoe.
• Oregon Health & Science University, Department of Family Medicine, 3181 SW Sam Jackson Park Rd., FM, Portland, OR 97239, United States. Electronic address: heintzma@ohsu.edu.
• Prev Med. 2014 Oct 1; 67: 306310306-10.

ObjectiveThis study compared the preventive service utilization of uninsured patients receiving care at Oregon community health centers (CHCs) in 2008 through 2011 with that of continuously insured patients at the same CHCs in the same period, using electronic health record (EHR) data.MethodsWe performed a retrospective cohort analysis, using logistic mixed effects regression modeling to calculate odds ratios and rates of preventive service utilization for patients without insurance, or with continuous insurance.ResultsCHCs provided many preventive services to uninsured patients. Uninsured patients were less likely than continuously insured patients to receive 5 of 11 preventive services, ranging from OR 0.52 (95% CI: 0.35-0.77) for mammogram orders to 0.75 (95% CI: 0.66-0.86) for lipid panels. This disparity persisted even in patients who visited the clinic regularly.ConclusionLack of insurance is a barrier to preventive service utilization, even in patients who can access care at a CHC. Policymakers in the United States should continue to address this significant prevention disparity.Copyright © 2014 Elsevier Inc. All rights reserved.

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