 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Dan Culica, MD, PhD, School of Public Health, University of Texas Health Science Center at Houston, 5323 Harry Hines Blvd., V8.300, Dallas, TX 75390, 214-648-1070, dan.culica@utsouthwestern.edu, Jim Walton, DO, Office of Community Health, HealthTexas Provider Network, Baylor Health Care System, 8080 N. Central Expressway, Suite 1700, Dallas, TX 75206, and Nora Gimpel, MD, Department of Family Practice and Community Medicine, UT Southwestern Medical Center Dallas, 6263 Harry Hines Blvd., Dallas, TX 75390-9067.
The objective of this randomized comparison group study is to test the effect of an alternative model of care for uninsured patients on emergency department (ED) utilization, hospitalization, and related costs in a major hospital. The main health outcome of interest is utilization of the ED and possibly subsequent hospitalization for ambulatory care sensitive conditions by uninsured patients. Higher use is defined as more than one standard deviation above the mean number of ED visits for all uninsured patients. Descriptive and correlation analysis will be performed measuring the number of non-emergent visits to the ED, hospitalizations, and associated costs, controlling for personal and clinical characteristics of the patients. Data will be provided by hospital records and medical charts furnished by the alternative model of care.
Study subjects are uninsured patients who visit the hospital more frequently for ambulatory care sensitive conditions. Approximately twenty-five patients of the target group will be selected monthly and enrolled in "Project Access," an alternative care model providing access to care for the working poor in Dallas, Texas. The remaining uninsured patients identified as higher users will represent the control group. Estimates of the last years' visits to the emergency department showed that approximately 9.4% of all patients using the ED are high users and almost 32% of those were uninsured. Both groups will be followed over time and comparative evaluations will be made every six months. Our hypothesis is that patients enrolled in Project Access will utilize the ED less for ambulatory care sensitive conditions.
Learning Objectives:
Keywords: Underserved Populations, Health Care Utilization
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.