Low-income uninsured patient health and access to health care through a community health program in NC.

Project Access provides free primary and specialty care for low-income uninsured residents of Buncombe County, NC through a physician volunteer network. In 2010, we replicated a 1998 study investigating health issues among Project Access (PA) patients. Over 300 patients enrolled in PA in 2009 were surveyed by telephone. Currently, as compared to 1998, fewer patients were employed (31% vs. 44.2%, p < 0.05), more patients were unable to return to work (15.6% vs. 8%, p < 0.05), and patients were enrolled in PA for longer (24.5 months vs. 14 months). The SF-12 Physical Health score was worse in 2010 (p < 0.05). With the implementation of Health Reform, certain groups of people will still require PA services, but a significant portion will be covered by Medicaid; with our PA patients reporting poorer health status, Medicaid resources may be strained even more than anticipated.