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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
3271.0: Monday, December 12, 2005 - 3:00 PM

Abstract #113658

Access to specialty care for the uninsured and publicly-insured in New Haven, Connecticut

Kari Hartwig, DrPH1, Marie Harris1, Katrina Clark, MPH2, Robyn Hoffmann, RN, MSN3, June Holmes, LCSW4, James Rawlings, MPH4, and Cornell Scott, MD5. (1) Yale University, School of Public Health, 60 College Street, P.O. Box 208034, New Haven, CT 06520, (203) 785-5553, kari.hartwig@yale.edu, (2) Fair Haven Community Health Center, 374 Grand Avenue, New Haven, CT 06513, (3) Hospital of Saint Raphael, 1450 Chapel Street, New Haven, CT 06511, (4) Yale New Haven Hospital, 20 York Street, New Haven, CT 06510, (5) Hill Health Center, 400 Columbus Avenue, New Haven, CT 06519

Objective: To document formative research on the experiences of New Haven area safety net providers referring uninsured, Medicaid, and SAGA (State-Administered General Assistance) patients for specialty services in Gastroenterology (GI) and Cardiology since Connecticut state budget cuts in 2002 conducted by an academic-community partnership. Background: The Greater New Haven Partnership for a Healthy Community is a consortium of area health providers, advocacy agencies, and Yale's School of Public Health. Consortium members were having increased difficulty getting timely referrals to a variety of specialists for uninsured patients, Medicaid and SAGA enrollees. Methods: Data collection methods included key informant interviews with (1) referral staff at the 5 participating hospitals and health centers and (2) specialty physicians; statistical analyses of the two hospital databases examining payer mix, time to appointment, and number of visits; analysis of the State's Cancer Register for county-level incidence rates for colon, prostate, breast and lung cancers over the previous 15 years; and documentation of Medicaid reimbursement rates for Cardiology and GI versus private insurers' rates. Results: These formative research results highlight the perceptions of referral staff and specialty care providers regarding barriers to specialty care for the uninsured and publicly-insured; strengths of community-academic partnerships and recommendations for improving access to specialists at the state and local level. The results also have implications for other communities across the country experiencing difficulty accessing specialty care for their uninsured and Medicaid populations.

Learning Objectives:

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

[ Recorded presentation ] Recorded presentation

Helping the Uninsured to Access Services and Medications

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA