Characteristics of Clients Using a Free Health Center

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Characteristics of Clients Using a Free Health
Center
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About the CCCHC

• Champaign County Christian Health Center is a
  not for profit health center founded in 2003. Our
  mission is to show and share the love of Jesus
  Christ to our neighbors of Champaign County by
  providing holistic, free, and quality health care
  services.
• 507 S. Second St.Suite 2EChampaign, IL
  61820ccchc2003_at_yahoo.com 
• http//www.ccchc2003.org

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About the CCCHC

• Provides
• primary care
• immunizations
• physicals
• screenings
• educational events
• prayer and support

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Problem Objectives

• Problem
• A large population of uninsured and underinsured
• Limited access to healthcare
• Over-utilization of Emergency Department (ED)
• Objectives
• Assess the clients of the Champaign County
  Christian Health Center
• Demographic Characteristics
• Health Service Utilization

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Methodology

• Self-reported client surveys completed before
  receiving services from the Champaign County
  Christian Health Center (CCCHC)
• Ten optional questions that included demographic
  information and health service utilization
• English and Spanish translations provided
• 970 cases reviewed
• Secondary data analysis using (SPSS) Statistical
  Package for the Social Sciences

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Scholarly literature review of free health clinic
clientele

• 75 of patients uninsured
• Over half lived within 200 of federal poverty
  level
• Minorities make up 60 of the uninsured American
  population
• Minority populations face
• lower quality of health care
• lack access to care

Williams, David R and Jackson, Pamela Braboy
Social Sources of Racial Disparities in Health,
(2005, March/April), Health Affairs Vol. 24(2)
Nadkarni, M. M. Philbrick, J. T. (2005). Free
clinics A national survey. American Journal of
the Medical Sciences, 330(1), 25-31.
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http//quickfacts.census.gov/gfd/states/17/17019.h
tml
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http//quickfacts.census.gov/gfd/states/17/17019.h
tml
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http//quickfacts.census.gov/gfd/states/17/17019.h
tml
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Average National Emergency Department Utilization
Statistics

• In 2005, 115.3 million visits to EDs (39.6
  visits per 100 people).
• An average of 30,000 visits per ED, a 31
  increase from 1995.
• 41.9 million injury-related ED visits (14.4
  visits per 100 people)

Nawar EW, Niska RW, Xu J ( 2007) National
Hospital Ambulatory Medical Care Survey 2005
Emergency Department Summary. Advance data from
vital and health statistics no. 386. National
Center for Health Statistics http//www.cdc.gov/nc
hs/data/ad/ad396.pdf
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Costs of ED Visits

• In 2003, average expenditure for an ED visit was
  560
• Average of 121 for an office-based visit
• Highest average ED expense for ages 4564 at 832
• ED expenses were slightly higher for males than
  for females

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Nawar EW, Niska RW, Xu J ( 2007) National
Hospital Ambulatory Medical Care Survey 2005
Emergency Department Summary. Advance data from
vital and health statistics no. 386. National
Center for Health Statistics http//www.cdc.gov/nc
hs/data/ad/ad396.pdf
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Scholarly literature findings on emergency
department utilization among uninsured

• 25 patients visiting EDs as primary source of
  health care
• 15-25 using ED as only source of care
• Strongest indicator of ED use is insurance status

Hong, Rick, Baumann, Brigitte M. and Boudreaux,
Edwin D ( 2007) The emergency department for
routine healthcare Race/ethnicity, socioeconomic
status, and perceptual factors Electronic
Version Journal of Emergency Medicine Vol.
32, Issue 2, pp 149-158
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Top Patient Reasons for Emergency Department Visit
Nawar EW, Niska RW, Xu J ( 2007) National
Hospital Ambulatory Medical Care Survey 2005
Emergency Department Summary. Advance data from
vital and health statistics no. 386. National
Center for Health Statistics http//www.cdc.gov/nc
hs/data/ad/ad396.pdf
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Urgency of ED Conditions National vs. CCCHC

Unknown
Urgent
Urgent
Non-urgent
Non-urgent
plt.001
Nawar EW, Niska RW, Xu J ( 2007) National
Hospital Ambulatory Medical Care Survey 2005
Emergency Department Summary. Advance data from
vital and health statistics no. 386. National
Center for Health Statistics http//www.cdc.gov/nc
hs/data/ad/ad396.pdf
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Nawar EW, Niska RW, Xu J ( 2007) National
Hospital Ambulatory Medical Care Survey 2005
Emergency Department Summary. Advance data from
vital and health statistics no. 386. National
Center for Health Statistics http//www.cdc.gov/nc
hs/data/ad/ad396.pdf
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N/A
N/A
N/A
Nawar EW, Niska RW, Xu J ( 2007) National
Hospital Ambulatory Medical Care Survey 2005
Emergency Department Summary. Advance data from
vital and health statistics no. 386. National
Center for Health Statistics http//www.cdc.gov/nc
hs/data/ad/ad396.pdf
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(No Transcript)
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Nawar EW, Niska RW, Xu J ( 2007) National
Hospital Ambulatory Medical Care Survey 2005
Emergency Department Summary. Advance data from
vital and health statistics no. 386. National
Center for Health Statistics http//www.cdc.gov/nc
hs/data/ad/ad396.pdf
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Limitations

• Self-reported data
• Difficulties in interpretation
• Surveys were not completed by all clients
• Surveys were collected over a two year period
  without date-stamping

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Conclusions

• High rate of minority, female head of household,
  and patients ages 25-64 using the free clinic
• CCCHC patients followed national ED utilization
  trends among uninsured
• Implications for ED overcrowding

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References

• 1.) Cardarelli, R. Chiapa, A. (2007). Educating
  primary care clinicians about health disparities.
  
• Osteopathic Medicine and Primary Care, 1(5).
  Retrieved June 9, 2008 from
• http//www.pubmedcentral.nih.gov/articlerender.fcg
  i?artid1808470.
• 2.) Cheong, P. H., Feeley, T. H. Servoss, T.
  (2007). Understanding health inequalities for
• uninsured Americans A population-wide survey.
  Journal of Health Communication, 12(3), 285-300.
• 3.) Davidson, R. A., Guancola, A., Gast, A., Ho,
  J. Waddell, R. (2003).  Evaluation of access, a
  
• primary care program for indigent patients
  Inpatient and emergency room utilization.
   Journal of Community
• Health, 28, 59-64.
• 4.) Diesburg-Stanwood, A., Scott, J., Oman, K.
  Whitehill, C. (2004). Nonemergent ED patients
• referred to community resources after medical
  screening examination Characteristics, medical
  condition after 72 hours,
• and use of follow-up services. Journal of
  Emergency Nursing, 30(4), 312-317.
• 5.) Hong, R., Baumann, B. M. Boudreaux, E. D.
  (2007). The emergency department for routine
• healthcare Race/ethnicity, socioeconomic status,
  and perceptual factors. Journal of Emergency
  Medicine, 32(2), 149
• 158.
• 6.) Machlin, S. R. (2006). Expenses for a
  hospital emergency room visit. Agency for
  Healthcare
• Research and Quality, 111. Retrieved June 11,
  2008 from
• http//www.meps.ahrq.gov/mepsweb/data_files/public
  ations/st111/stat111.pdf.
• 7.) Mayer, G. G., Villaire, M. Connell, J.
  (2005). Ten recommendations for reducing
• unnecessary emergency department visits. Journal
  of Nursing Administration, 35(10), 428-430.

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• Compiled by Jennifer Byelick (2008)