Weihao Zhou

The authors aimed to investigate potential differences between health care use and related payments for patients with complex needs and high costs in Health Resources and Services Administration-funded health centers (HC) and with other safety net primary care providers. They used data from the California Health Homes Program that was designed to improve health outcomes and reduce expenditures of such Medicaid managed care beneficiaries. The authors used 2018 data prior to program implementation and conducted propensity score-matched regressions and then estimated predicted rates of use across seven service categories and payment values for each category and for overall payments.

Findings: The authors found that 29% of the sample were HC patients and had lower estimated average total payment values ($21,220) than group provider patients ($23,180). HC patients also had lower values for hospitalizations and long-term facility stays and higher values for primary and mental health services than all other providers. Payment differences were generally consistent with differences in predicted rates of use. These findings suggest that HC approaches to managing patient care access and integrated mental health services may explain these differences in use and payment patterns.
 

Youth comprise one-third of the U.S. homeless population. However, little is known about how homelessness affects health care utilization. Authors examine associations of homelessness with hospitalization, primary care, and emergency department (ED) visits, varying by race/ethnicity, among Medicaid-enrolled youth.

Findings: Approximately 17% of sampled youth experienced homelessness in 2018 (N=90,202). Compared with their housed counterparts, youth experiencing homelessness had a 1.9 percentage point (pp) higher likelihood of frequent ED visits but a 2.9 pp lower probability of any primary care visits. Homelessness was associated with 221 more ED visits, 100 more preventable ED visits, 19.9 more hospitalizations, but 56 fewer primary care visits, per 1,000 youth. The associations of homelessness with total ED visits, preventable ED visits, and needed and nonpreventable ED visits were all higher among whites and, particularly, Blacks, than for Hispanics and Asians.

Medicaid-enrolled youth who experienced homelessness had more overall ED, preventable ED, and hospital visits, but fewer primary care visits than their housed peers. Results suggest promoting primary care use should be considered among strategies to improve health and reduce costs.
 

Summary: In this infographic brief, the UCLA Center for Health Policy Research summarizes information from their evaluation of the 2022 Parks After Dark (PAD) program in Los Angeles County. PAD is a county initiative led by the Department of Parks and Recreation in partnership with other county departments and community-based organizations. PAD programming — including sports, entertainment, activities, and more — was offered for eight weeks on Thursday, Friday, and Saturday evenings at 34 parks between June and August 2023.

Findings: Evaluators found that PAD has made significant progress in achieving its intended goals through the provision of quality recreational programming in a safe and family-friendly environment. Besides ensuring participant’s sense of safety at parks while attending PAD programming, evidence indicates that PAD may have reduced crime in PAD parks and their surrounding areas since its inception in 2010. In addition, PAD encouraged meaningful collaboration between participating county departments and community-based organizations; contributed to participant’s feelings of well-being, family togetherness, and social cohesion; and involved a diverse range of participants in community-driven programming in a meaningful way. PAD may also have reduced the burden of disease for those that engaged in exercise opportunities.

Read the Publications:

• Evaluation Brief: 
  • Parks After Dark Evaluation Brief, May 2024 (English) 
  • Parks After Dark Evaluation Brief, May 2024 (Spanish)
• Full Evaluation Report: Parks After Dark Evaluation Report, May 2024
   

Previous years:

• Parks After Dark Evaluation Brief, July 2023 
• Parks After Dark Evaluation Report, July 2023 
• Parks After Dark Evaluation Brief, July 2018 
• Parks After Dark Evaluation Report, July 2018 
• Parks After Dark Evaluation Brief, May 2017 
• Parks After Dark Evaluation Report, May 2017 

Summary: In this report, the UCLA Center for Health Policy Research provides information from their evaluation of the 2023 Parks After Dark (PAD) program in Los Angeles County.

PAD is a Los Angeles County initiative led by the Department of Parks and Recreation (DPR) in partnership with other County departments and community-based organizations. Thirty-four DPR parks hosted PAD between June and August 2023. PAD was offered three nights a week for eight weeks, on Thursday, Friday, and Saturday evenings. In 2022, PAD expanded to include one-day events around spring and winter school breaks.

Select 2023 evaluation findings include:

• Difference-in-difference (DD) analysis indicated a reduction in crime rates in PAD parks after implementation of PAD when compared to similar parks that did not implement PAD, with 74 fewer Part I crimes and 43 fewer Part II crimes between 2010 and 2023 in all PAD parks. As indicated in 2023 PAD participant surveys, among PAD attendees who expressed not feeling safe in their neighborhood, 64% felt safe at PAD.
• In key informant surveys, PAD partners strongly agreed that PAD improved collaboration between County departments and community-based organizations (9.3 of 10).
• In 2023 PAD participant surveys, attendees overwhelmingly reported that PAD increased quality time with family members (96%), provided a sense of belonging within the community (96%), and improved their relationship with their neighbors (94%).
• Of attendees who did not meet the recommended activity guidelines for their age, 76% participated in physical activity at PAD. Using a modified version of the Integrated Transport and Health Impacts Model (ITHIM), the level of physical activity at PAD, if sustained year-round, would primarily reduce stroke and ischemic heart disease and lead to an overall decline of 20 years of life lost, 20 fewer years of disability adjusted life years, and avoidance of two premature deaths for the entire PAD population in 2023.
• A vast majority of attendees expressed high levels of satisfaction, with 97% saying they would attend PAD again and 97% also said they would recommend PAD to others. 

The 2023 evaluation findings demonstrate that PAD has made significant progress in achieving its intended goals through the provision of quality recreational programming in a safe and family-friendly environment. Evidence indicates that PAD may have reduced crime in PAD parks and their surrounding areas since its inception in 2010, while also ensuring participant’s sense of safety. Findings further indicate that PAD encouraged meaningful collaboration between participating County departments and community-based organizations; contributed to participant’s feelings of well-being, family togetherness, and social cohesion; and meaningfully involved a diverse range of participants in community-driven programming (including youth and seniors). PAD offered sports, entertainment, and other activities for children and adults with no barriers to participation and may have reduced the burden of disease for those that engaged in exercise opportunities. Overall, participant satisfaction levels at PAD remain high each year.

Read the Publications: 

• Evaluation Report: Parks After Dark Evaluation Report, May 2024
• Appendix A: Evaluation Methods
• Appendix B: Additional Data
• Appendix C: Service Use in ZIP Codes around PAD Parks
• Evaluation Brief: Parks After Dark Evaluation Brief, May 2024

Previous years:

• Parks After Dark Evaluation Brief, July 2023 
• Parks After Dark Evaluation Report, July 2023 
• Parks After Dark Evaluation Brief, July 2018 
• Parks After Dark Evaluation Report, July 2018 
• Parks After Dark Evaluation Brief, May 2017 
• Parks After Dark Evaluation Report, May 2017