Perspectives of patients at U.S. free clinics: Findings from a national study

OBJECTIVES: 1) To describe attitudes and beliefs of patients attending U.S. free-clinics, and 2) To identify factors associated with self-perceived health status. METHODS: Ten patient surveys were mailed to 172 free clinic directors who participated in an online survey. Forty-one clinics returned 362 surveys. Descriptive statistics and Pearson-chi-squared tests were used to examine significant differences regarding quantitative and qualitative responses. RESULTS: Ninety-four percent of patients reported that their health had caused them stress in the past year. Hispanics and those ages 65+ were least likely to report this (p=0.0004, p=0.0339). Seventy percent said, compared to others their age, their health was the same or worse. African Americans, Hispanics, and those ages 35-64 were least likely to report this (p=0.0034,p=0.0284). Married patients and patients who lived with their partner were more likely than single patients or those identifying as ‘other' to report receiving a medium to high amount of encouragement from their friends and family (p=0.0034). Ninety-five percent of patients' open-ended comments were positive. Representative examples include: “They allow you to keep your self respect”, “Thanks for being there when no one else cares”, and “Probably would be deceased if not for the clinic”. CONCLUSIONS: The majority of free clinic patients report high levels of health related stress. At the same time, the majority indicates that free clinics have provided much needed support. Free clinics seem to provide something more then health care; they also provide hope to the many uninsured and low-income patients that they serve.