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The Financial Impact of a Partnership Between an Academic Medical Center and a Free Clinic.
Wallace, Shelby; Johnson, Tricia J; Hendel, Emily; Chakravarthy, Vidya; Leanos, Lizette; Ansell, David A.
Afiliación
  • Wallace S; Department of Health Systems Management, Rush University, Chicago, Ill.
  • Johnson TJ; Department of Health Systems Management, Rush University, Chicago, Ill. Electronic address: tricia_j_johnson@rush.edu.
  • Hendel E; CommunityHealth, Chicago, Ill.
  • Chakravarthy V; Department of Health Systems Management, Rush University, Chicago, Ill; Population Health, Rush University Medical Center, Chicago, Ill.
  • Leanos L; Population Health, Rush University Medical Center, Chicago, Ill; Clinical Information Systems, Rush University Medical Center, Chicago, Ill.
  • Ansell DA; Department of Internal Medicine, Rush University Medical Center, Chicago, Ill.
Am J Med ; 134(11): 1389-1395.e4, 2021 11.
Article en En | MEDLINE | ID: mdl-34283952
PURPOSE: The objective of this study is to examine the association between an academic medical center and free clinic referral partnership and subsequent hospital utilization and costs for uninsured patients discharged from the academic medical center's emergency department (ED) or inpatient hospital. METHODS: This retrospective, cross-sectional study included 6014 uninsured patients age 18 and older who were discharged from the academic medical center's ED or inpatient hospital between July 2016 and June 2017 and were followed for 90 days in the organization's electronic medical record to identify the occurrence and cost of subsequent same-hospital ED visits and hospital admissions. The occurrence of any subsequent ED visits or hospital admissions and the cost of subsequent hospital care were compared by free clinic referral status after inverse probability of treatment weighting. RESULTS: Overall, 330 (5.5%) of uninsured patients were referred to the free clinic. Compared with patients referred to the free clinic, patients not referred had greater odds of any subsequent ED visits or hospital admissions within 90 days (odds ratio, 1.8; 95% confidence interval: 1.7-2.0). For patients with any subsequent ED visits or hospital admissions, the mean cost of care for those who were not referred to the free clinic was 2.3 times higher (95% confidence interval: 2.0-2.7) compared to referred patients. CONCLUSION: An academic medical center-free clinic partnership for follow-up care after discharge from the ED or hospital admission is a promising approach for improving access to care for uninsured patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Derivación y Consulta / Pacientes no Asegurados / Servicios de Salud Comunitaria / Servicio de Urgencia en Hospital / Centros Médicos Académicos / Instituciones de Atención Ambulatoria / Hospitalización Tipo de estudio: Diagnostic_studies / Health_economic_evaluation / Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Med Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Derivación y Consulta / Pacientes no Asegurados / Servicios de Salud Comunitaria / Servicio de Urgencia en Hospital / Centros Médicos Académicos / Instituciones de Atención Ambulatoria / Hospitalización Tipo de estudio: Diagnostic_studies / Health_economic_evaluation / Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Med Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos