Skip to main content
SpringerLink
Log in

Evaluation of ACCESS, a Primary Care Program for Indigent Patients: Inpatient and Emergency Room Utilization

  • Published:
Journal of Community Health Aims and scope Submit manuscript

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 $1174 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Martin BC. Emergency medicine versus primary care: A case study of three prevalent, costly, and non-emergent diagnoses at a community teaching hospital. J Health Care Finance 2000;27:51-65.

    PubMed  Google Scholar 

  2. Phelps K, Taylor C, Kimmel S, Magel R, Klein W, Puczynski S. Factors associated with emergency department utilization for nonurgent pediatric problems. Arch Fam Med 2000;9:1086-1092.

    Article  PubMed  Google Scholar 

  3. Okin RL, Boccellari A, Azocar F, Shumway M, O’Brien K, Gelb A, Kohn M, Harding P, Wachsmuth C. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med 2000;18:603-608.

    Article  PubMed  Google Scholar 

  4. Powers R. Emergency department use by adult Medicaid patients after implementation of managed care. Acad Emerg Med 2000;7:1416-1420.

    PubMed  Google Scholar 

  5. Nykamp D, Ruggles D. Impact of an indigent care program on use of resources: experiences at one hospital. Pharmacotherapy 2000; 20:217-220.

    Article  PubMed  Google Scholar 

  6. DeSalvo A, Rest SB, Nettleman M, Freer S, Knight T. Patient education and emergency room visits. Clin Perform Qual Health Care 2000;8:35-37.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Office of Generalist Education and the Community Health Scholars Program (North Florida Area Health Education Center), USA;

    Richard A. Davidson & Rhondda Waddell

  2. University of Florida College of Medicine, Gainesville, Florida

    Richard A. Davidson, Angela Giancola, Andrea Gast & Janice Ho

Authors
  1. Richard A. Davidson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Angela Giancola
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea Gast
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Janice Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rhondda Waddell
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Davidson, R.A., Giancola, A., Gast, A. et al. Evaluation of ACCESS, a Primary Care Program for Indigent Patients: Inpatient and Emergency Room Utilization. Journal of Community Health 28, 59–64 (2003). https://doi.org/10.1023/A:1021333222164

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1021333222164

Search

Navigation