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UTILIZATION OF FREE HEALTH CLINICS IN AN UNDERSERVED POPULATION Christina Kim, Marium Khan and Theresa Osunero.

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Presentation on theme: "UTILIZATION OF FREE HEALTH CLINICS IN AN UNDERSERVED POPULATION Christina Kim, Marium Khan and Theresa Osunero."— Presentation transcript:

1 UTILIZATION OF FREE HEALTH CLINICS IN AN UNDERSERVED POPULATION Christina Kim, Marium Khan and Theresa Osunero

2 Background Information: U.S. Statistics 2009: 50.7 million 1 uninsured From 2008 – 2009: people sponsored by employment-based health insurance decreased 3.3% 1 $2.5 trillion spent on health care in Unemployment rate rose to 9.6%, compared to 4.5% in

3 Background Information Causes of an increase in the uninsured population: Decrease in employment-based health insurance Increase in the cost of health care Patient Protection and Affordable Care Act: Still leaves approximately 23 million people without insurance coverage

4 Free Health Clinic Defined Private, nonprofit, community-based organization Primary and secondary medical care Dental care Pharmaceutical Laboratory Mental health services

5 Purpose of Free Health Clinics Over 1,000 free clinics distributed across the United States 3 Nationally, free clinics serve 38% of the uninsured population , visits to community health centers by uninsured patients increased by 21% 4 Providing a safety net for underserved populations

6 Demographics of Patients Nationally Low-income Uninsured Disproportionately female Age:20-44 years old 5 Nearly half came from rural areas 6

7 Top Three Conditions Top three chronic conditions diagnosed: 1. Cardiovascular disease 2. Hypertension 3. Diabetes Nearly one third of the uninsured nonelderly U.S. adults had at least one chronic condition 7 Approximately three times more likely to seek care for chronic conditions compared to insured patients who go to physician offices 5

8 Champaign County Christian Health Center (CCCHC) Mid-sized organization that provides free, holistic, quality health care from volunteer physicians to anyone who lacks health insurance 8 Opened Fall 2004, once a week for three hours in the evening Served over 2,000 patients in Champaign County 9

9 Purpose of Research Study Determined the demographic characteristics of the uninsured people who utilized the free health clinic Determined the purpose for client visits

10 Methods Collected over 2,000 paper medical records from all patient visits from 2004 – 2009 Chi-square analysis performed using SPSS 17.0 Conditions categorized into ICD- 10 Chapters Data collected: Address, year of birth, gender, blood pressure, height, weight, smoking status, health history, social service needs, and medical condition

11 Results: Patient Reason for Visit Table 1. Patient Visits Patient Reasons for Visit Medical Condition72.5 Test or Exam 21.1 Prescription Refills 6.4 Percent of Patient Visits Percentage of patient visits is based on data collected at CCCHC

12 Results: ICD-10 Chapters Percentage of Client Visits Clinic Top ICD-10 Chapters% of Patient Visits National Top ICD-10 Chapters% of Visits Diseases of the Respiratory System 16.3Diseases of the Respiratory System 10.6 Diseases of Circulatory System14.9Mental and Behavioral Disorders7.2 Mental and Behavioral Disorders12.4Endocrine, Nutritional, and Metabolic Disorders 7.0 Disease of the Musculoskeletal System and Connective Tissue 9.4Symptoms, Signs, and Abnormal Clinical and Laboratory 6.9 Diseases of the Digestive System7.9Findings, Not Elsewhere Classified6.6

13 Results: Health Condition Breakdown Into Percentages Table 3. Health Condition Breakdown in Percentages Patient Characteristics Clinic County Illinois U.S. BMI Average28.7n/an/a26.5 Normal weight Overweight Obese BLOOD PRESSURE Normal Pre-Hypertension37.5n/an/a25.0 Hypertension SMOKING STATUS Smoker DEPRESSION

14 Results: Demographics of Patient Population Table 4. Demographic Breakdown in Percentages Patient Characteristics Clinic County Illinois U.S. GENDER Male Female AGE (years) Average UNINSURED

15 Discussion: Conditions No one condition exceedingly common Most frequent reason for visit Physical exam (17%)

16 Discussion: Demographics Clinic patients were female (56%) Patients at the clinic were years olds (90%) County residents (70%) 9

17 Discussion: Medical Conditions (ICD-10) 1. Diseases of the Respiratory System (16.3%) Accounted for symptoms as well as diseases such as asthma 2. Diseases of the Circulatory System (14.9%) Hypertension (28%) Single most common medical condition diagnosed at clinic 3. Mental & Behavioral Disorders (12.4%) Depression (12%) Could be attributed to the stress of living in poverty and being uninsured

18 Discussion: ICD-10 Diseases of Circulatory System Elevated percentage of hypertension, obesity, and smoking seen in clinic patients Leading contributors to developing cardiovascular disease High prevalence unknown ClinicCountyIllinois Percentage of Patients Diagnosed with Hypertension Percentage of Patients Diagnosed Obesity ClinicCountyIllinois Percentage of Smokers ClinicCountyIllinois

19 Discussion: Homeless Population 121 non-residential addresses Common places known to shelter the homeless: Local churches Homeless shelters Other community organizations Worse health conditions and more health care needs Higher rates of medical conditions than the general clinic population

20 Limitations Hours Only about 5% of the total uninsured population in the county Lack of standardization and inconsistency in documentation Records did not provide ethnicity, which restricted comparisons to previous studies Census 2000 demographic information was used which may have been outdated at the time of the analysis

21 Conclusion Clinics should offer a full spectrum of services Future studies could explore Improvement of a health care delivery system High prevalence of smoking Obesity Self-reported social service needs Utilization of the clinic by the areas homeless population

22 References 1. U.S. Census Bureau. Income, poverty, and health insurance coverage in the United States: Washington, DC: U.S. Department of Commerce, Davis, Karen (2010). New Report on National Health Expenditures Underscored Need for Comprehensive Health Care Reform. The Commonwealth Fund. Retrieved from 3. Bureau of Labor Statistics. Local area unemployment statistics. Washington, DC: United States Department of Labor, Redlener I, Grant R. Americas safety net and health care reformWhat lies ahead? New England Journal of Medicine Dec 3; 361(23): Rosenbaum S, Jones E, & Shin P. Community health centers: Opportunities and challenges of health reform. The Henry J. Kaiser Family Foundation, Available at 6. Keis RM, DeGeus LG, Cashman S, et al. Characteristics of patients at three free health clinics. Journal of Health Care for the Poor and Underserved 2004;15: Wilper AP, Woolhandler S, Lasser KE, et al. A national study of chronic disease prevalence and access to care in uninsured U.S. adults. Annals of Int Med 2008 Aug 05;149(3): , 7p, 4 charts 8. Champaign County Christian Health Center (on-line). Available: 9. U.S.. Census Bureau. State and county quick facts: Illinois. Washington, DC: U.S. Department of Commerce, Issacs SL & Jellinek P. Grant Watch Report: Is there a (volunteer) doctor in the house? Free clinics and volunteer physician referral networks in the United States. Health Affairs 2007;26(3): Nadkarni MM & Philbrick JT. Free Clinics and the Uninsured: The increasing demands of chronic illness. Journal of Health Care for the Poor and Underserved 2003 May; 14(2): County Health Rankings. Snapshot 2010 Champaign, IL. Retrieved from 13. U.S. Census Bureau. Illinois: American community survey 3-year estimates. Washington, DC: U.S. Department of Commerce, U.S Census Bureau. Current Population Survey: Annual Social and Economic Supplement Washington, DC: U.S. Department of Commerce, Behavioral Risk Factor Surveillance System. County level prevalence data. Champaign, Springfield, IL: Illinois Department of Public Health. 16. Center for Disease Control and Prevention. High blood pressure facts. Atlanta, GA: National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention, Behavioral Risk Factor Surveillance System. Prevalence and Trends Data. Centers for Disease Control and Prevntion, Behavioral Risk Factor Surveillance System. Illinois and Strata area prevalence data. Champaign, Springfield, IL: Illinois Department of Public Health. 19. Community Health Status Indicators. Vulnerable Populations – Champaign County, IL. Department of Health and Human Services, Hing E, Hall MJ, & Xu, J. National Health Statistics Reports. National hospital ambulatory medical care survey: 2006 Outpatient department summary. Atlanta, GA: Centers for Disease Control and Prevention, 2008.

23 Questions?

24 Thank you to the Provost Office and the Undergraduate Research Symposium


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