199533 Assessing the longitudinal impact of a rural Federally Qualified Health Center on preventable uninsured Emergency Department visits

Tuesday, November 10, 2009

Betty Smith-Campbell, RN, PhD , Associate Professor, School of Nursing, Wichita State University, Wichita, KS
David W. Wright, PhD , Professor, Deptartment of Sociology, Wichita State University, Wichita, KS
Background/Purpose: Rural and urban communities are experiencing a health care crisis due to over and inappropriate use of emergency departments (ED). Inappropriate use of the ED is inefficient and costly, and health centers have been shown to decrease the use of the ED for Ambulatory Care Sensitive Conditions (ACSC) that can be cared for in a primary health care setting. This is an extension of an initial study that assessed the impact of a rural Federally Qualified Community Health Center (FQHC) on uninsured ED visits prior to (2000) and after (2005) the center was established (2003). This study provides follow-up data for 2006 and 2007. Specifically assessed were FQHC program changes after 2005 and how the changes influenced ACSC uninsured ED visits.

Methods: Annual county hospital ED and FQHC data were analyzed and collected retrospectively from computer generated reports, 2000-2007. An algorithm was used to classify ACSC ED visits.

Results: The percent of the uninsured population visiting the ED dropped immediately the year the FQHC was established for Emergent-primary care treatable and non-emergent visits. There was no notable decrease for Emergent-ED care needed-preventable visits. Preliminary results of the raw data were similar for 2006 and 2007; final analysis will be complete the summer of 2009.

Conclusions: Results suggest the new interventions at the rural FQHC decreased the cost and number of ACSC uninsured ED visits. FQHCs have the potential to be a preventative strategy to decrease inappropriate uninsured ED visits.

Learning Objectives:
At the end of the session the participant will be able to: 1. Identify the impact one rural Federally Qualified Health Center had on the local hospitalís uninsured Emergency Department visits 2.Describe Emergency Department Ambulatory Care Sensitive Condition visits that may be prevented by primary health care.

Keywords: Community Health Centers, Emergency Department/Room

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI for the research study and have collected the data and with my research associate continue to analyze the data. This research project builds on similar past research studies that have been completed and published
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.