4075.0: Tuesday, November 14, 2000 - Board 5

Abstract #9931

Improving utilization of health services by a low-income, culturally-diverse population

Susan Karlins, MPH1, Kent Imai, MD1, Julie Grisham, PHN, MA2, Greg Price1, Immaculate S. Cantos, MPHc1, Nhien Luong, MPH2, Rocio Gonzalez, MPH2, Bonnie Broderick, MPH2, and Caroline Yip, MHA1. (1) Valley Health Plan, Santa Clara Valley Health and Hospital System, 3003 Moorpark Avenue, San Jose, CA 95128, (408) 885-4038, karlisus@wpgate.hhs.co.santa-clara.ca.us, (2) Santa Clara County Public Health Department, Santa Clara Valley Health and Hospital System, 645 S. Bascom Avenue, San Jose, CA 95128

Prior to 1997, many members of Santa Clara County’s diverse Medi-Cal population had no regular source of preventive and acute medical care and used the Emergency Department (ED) for episodic urgent care. Since then, Valley Health Plan created a “medical home” for each member at a clinic and expanded after-hours telephone triage and urgent care options. Nevertheless, almost 90% of this population’s ED visits were for non-emergency care. Many members were unaware of their provider and how to effectively access care. This population, with a greater risk of health problems, was more likely to access care at the ED where preventive services are minimal. Intervention In 1998, an innovative program was developed to improve patterns of care by changing member knowledge, attitudes, and behaviors and decreasing barriers to primary and urgent care. Program strategies were based upon behavior change theories and self-efficacy models. Bilingual Public Health workers contacted members who visited an area ED to 1) provide interactive education on the benefits of preventive/primary care and how to access care; 2) make follow up appointments; 3) assess barriers to care; and 4) refer to community resources. ED visits were chosen as a surrogate measure for improved utilization. Outcome The rate of ED utilization decreased 17% in the target population for the first seven months after the initial start-up period. Follow up data will be forthcoming. Barriers to access to preventive/primary care were identified; needs assessments conducted; and health education programs combined with administrative solutions are addressing these barriers.

Learning Objectives: At the conclusion of the presentation, participants will be able to:

Keywords: Health Education Strategies, Medicaid Managed Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employed by Santa Clara County Health and Hospital System which funded this project.

The 128th Annual Meeting of APHA