BACKGROUND: Approximately 19% of non-elderly adults are without health insurance. The uninsured frequently lack a source of primary care and are more likely to use the emergency department (ED) for routine care. Improving access to primary care for the uninsured is one strategy to reduce ED overutilization and related costs. METHODS: A comparison group quasi-experimental design was used to evaluate a broad-based community partnership that provided access to care for the uninsured-Project Access Dallas (PAD)-on ED utilization and related costs. Eligible uninsured patients seen in the ED were enrolled in PAD (n = 265) with similar patients not enrolled in PAD (n = 309) serving as controls. Study patients were aged 18-65 years, <200% of the federal poverty level and uninsured. Outcome measures include the number of ED visits, hospital days and direct and indirect costs. RESULTS: PAD program enrollees had significantly fewer ED visits (0.93 vs. 1.44; P < 0.01) and fewer inpatient hospital days (0.37 vs. 1.07; P < 0.05) than controls. Direct hospital costs were ∼60% less ($1188 vs. $446; P < 0.01) and indirect costs were 50% less ($313 vs. $692; P < 0.01). CONCLUSIONS: A broad-based community partnership program can significantly reduce ED utilization and related costs among the uninsured.
BACKGROUND: Approximately 19% of non-elderly adults are without health insurance. The uninsured frequently lack a source of primary care and are more likely to use the emergency department (ED) for routine care. Improving access to primary care for the uninsured is one strategy to reduce ED overutilization and related costs. METHODS: A comparison group quasi-experimental design was used to evaluate a broad-based community partnership that provided access to care for the uninsured-Project Access Dallas (PAD)-on ED utilization and related costs. Eligible uninsured patients seen in the ED were enrolled in PAD (n = 265) with similar patients not enrolled in PAD (n = 309) serving as controls. Study patients were aged 18-65 years, <200% of the federal poverty level and uninsured. Outcome measures include the number of ED visits, hospital days and direct and indirect costs. RESULTS: PAD program enrollees had significantly fewer ED visits (0.93 vs. 1.44; P < 0.01) and fewer inpatient hospital days (0.37 vs. 1.07; P < 0.05) than controls. Direct hospital costs were ∼60% less ($1188 vs. $446; P < 0.01) and indirect costs were 50% less ($313 vs. $692; P < 0.01). CONCLUSIONS: A broad-based community partnership program can significantly reduce ED utilization and related costs among the uninsured.
Authors: K Marie Reid-Lombardo; Charity Celeste Glass; Stuart G Marcus; Juliette Liesinger; Daniel B Jones Journal: J Gastrointest Surg Date: 2014-09-23 Impact factor: 3.452
Authors: Lesley J J Soril; Laura E Leggett; Diane L Lorenzetti; Tom W Noseworthy; Fiona M Clement Journal: PLoS One Date: 2015-04-13 Impact factor: 3.240
Authors: Vladimir Khanassov; Pierre Pluye; Sarah Descoteaux; Jeannie L Haggerty; Grant Russell; Jane Gunn; Jean-Frederic Levesque Journal: Int J Equity Health Date: 2016-10-10
Authors: Sara Willems; Wim Peersman; Philippe De Maeyer; Walter Buylaert; Jan De Maeseneer; Peter De Paepe Journal: BMC Fam Pract Date: 2013-09-14 Impact factor: 2.497
Authors: Mélanie Ann Smithman; Sarah Descôteaux; Émilie Dionne; Lauralie Richard; Mylaine Breton; Vladimir Khanassov; Jeannie L Haggerty Journal: Int J Equity Health Date: 2020-10-06