title: Evaluation of access, a primary care program for indigent patients: inpatient and emergency room utilization.
abstract: We analyzed the impact of a program that provides indigent patients with free primary care on inpatient admissions, emergency room (ER) visits, and resulting charges in 91 patients before and after admittance into the program. There was a decrease in ER visits after enrolling in the program (1.89 versus 0.83 visits per year; p < 0.0001). This difference translated into mean ER charges of $1,174 vs. $717 (p = 0.0007), and a decrease in charges of $41,587 per year. The charges for the program (outpatient visits and laboratory) were $23,141. Entry into the program had no effect on inpatient admissions, which averaged 0.07 admissions per year both before and after admission to the program. Indigent patients enrolled in a complimentary primary care program had significantly decreased per-year ER utilization rates and charges. The program had no effect on inpatient admissions. By conservative estimate, the program decreased ER charges by approximately $18,000 per year secondary to decreased ER utilization.
authors.affiliation: Office of Generalist Education and the Community Health Scholars Program (North Florida Area Health Education Center), University of Florida College of Medicine, Gainesville 32610, USA. Davidra@medicine.ufl.edu
authors.forename: Richard A
authors.initials: RA
authors.lastname: Davidson
authors.forename: Angela
authors.initials: A
authors.lastname: Giancola
authors.forename: Andrea
authors.initials: A
authors.lastname: Gast
authors.forename: Janice
authors.initials: J
authors.lastname: Ho
authors.forename: Rhondda
authors.initials: R
authors.lastname: Waddell
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D019468:Disease Management; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D005431:Florida; D005102:Health Expenditures; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008489:Medical Indigency; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration*; D012189:Retrospective Studies