2. About the CCCHC “Champaign County Christian Health Center is a not for profit health center founded in 2003. Our mission is to show and share the love of Jesus Christ to our neighbors of Champaign County by providing holistic, free, and quality health care services.” 507 S. Second St. Suite 2E Champaign, IL 61820 ccchc2003@yahoo.com http://www.ccchc2003.org

3. About the CCCHC Provides: primary care immunizations physicals screenings educational events prayer and support

4. Problem A large population of uninsured and underinsured Limited access to healthcare Over-utilization of Emergency Department (ED) Objectives Assess the clients of the Champaign County Christian Health Center Demographic Characteristics Health Service Utilization Problem & Objectives

5. Methodology Self-reported client surveys completed before receiving services from the Champaign County Christian Health Center (CCCHC) Ten optional questions that included demographic information and health service utilization English and Spanish translations provided 970 cases reviewed Secondary data analysis using (SPSS) Statistical Package for the Social Sciences

6. Scholarly literature review of free health clinic clientele 75% of patients uninsured Over half lived within 200% of federal poverty level Minorities make up 60% of the uninsured American population Minority populations face: lower quality of health care lack access to care Williams, David R and Jackson, Pamela Braboy Social Sources of Racial Disparities in Health, (2005, March/April), Health Affairs Vol. 24(2) Nadkarni, M. M. & Philbrick, J. T. (2005). Free clinics: A national survey. American Journal of the Medical Sciences, 330(1), 25-31.

7. http://quickfacts.census.gov/gfd/states/17/17019.html

9. **

11. Average National Emergency Department Utilization Statistics In 2005, 115.3 million visits to ED’s (39.6 visits per 100 people). An average of 30,000 visits per ED, a 31% increase from 1995. 41.9 million injury-related ED visits (14.4 visits per 100 people) Nawar EW, Niska RW, Xu J ( 2007) National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital and health statistics; no. 386. National Center for Health Statistics http://www.cdc.gov/nchs/data/ad/ad396.pdf

12. Costs of ED Visits In 2003, average expenditure for an ED visit was $560 Average of $121 for an office-based visit Highest average ED expense for ages 45–64 at $832 ED expenses were slightly higher for males than for females

13. Nawar EW, Niska RW, Xu J ( 2007) National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital and health statistics; no. 386. National Center for Health Statistics http://www.cdc.gov/nchs/data/ad/ad396.pdf

14. Scholarly literature findings on emergency department utilization among uninsured 25% patients visiting ED’s as primary source of health care 15-25% using ED as only source of care Strongest indicator of ED use is insurance status Hong, Rick, Baumann, Brigitte M. and Boudreaux, Edwin D ( 2007) The emergency department for routine healthcare: Race/ethnicity, socioeconomic status, and perceptual factors [Electronic Version] Journal of Emergency Medicine Vol. 32, Issue 2, pp 149-158

17. Top Patient Reasons for Emergency Department Visit CCCHC PatientsAverage National ED Patients in 2005 1. Injury1. Stomach/Abdominal Pain 2. Gastric Symptoms2. Chest Pain 3. Blood Pressure/ Problems3. Fever 4. Cardiac Symptoms4. Cough 5. Mental Health Conditions5. Headache, pain in head Nawar EW, Niska RW, Xu J ( 2007) National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital and health statistics; no. 386. National Center for Health Statistics http://www.cdc.gov/nchs/data/ad/ad396.pdf

18. Urgency of ED Conditions: National vs. CCCHC Non- urgent Urgent Non- urgent Urgent Unknown ***p<.001 *** Nawar EW, Niska RW, Xu J ( 2007) National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital and health statistics; no. 386. National Center for Health Statistics http://www.cdc.gov/nchs/data/ad/ad396.pdf

19. Nawar EW, Niska RW, Xu J ( 2007) National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital and health statistics; no. 386. National Center for Health Statistics http://www.cdc.gov/nchs/data/ad/ad396.pdf

20. *N/A Nawar EW, Niska RW, Xu J ( 2007) National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital and health statistics; no. 386. National Center for Health Statistics http://www.cdc.gov/nchs/data/ad/ad396.pdf

22. Nawar EW, Niska RW, Xu J ( 2007) National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital and health statistics; no. 386. National Center for Health Statistics http://www.cdc.gov/nchs/data/ad/ad396.pdf

23. Limitations Self-reported data Difficulties in interpretation Surveys were not completed by all clients Surveys were collected over a two year period without date-stamping

24. Conclusions High rate of minority, female head of household, and patients ages 25-64 using the free clinic CCCHC patients followed national ED utilization trends among uninsured Implications for ED overcrowding

25. References 1.) Cardarelli, R. & Chiapa, A. (2007). Educating primary care clinicians about health disparities. Osteopathic Medicine and Primary Care, 1(5). Retrieved June 9, 2008 from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1808470http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1808470. 2.) Cheong, P. H., Feeley, T. H. & Servoss, T. (2007). Understanding health inequalities for uninsured Americans: A population-wide survey. Journal of Health Communication, 12(3), 285-300. 3.) Davidson, R. A., Guancola, A., Gast, A., Ho, J. & Waddell, R. (2003). Evaluation of access, a primary care program for indigent patients: Inpatient and emergency room utilization. Journal of Community Health, 28, 59-64. 4.) Diesburg-Stanwood, A., Scott, J., Oman, K. & Whitehill, C. (2004). Nonemergent ED patients referred to community resources after medical screening examination: Characteristics, medical condition after 72 hours, and use of follow-up services. Journal of Emergency Nursing, 30(4), 312-317.Journal of Emergency Nursing 5.) Hong, R., Baumann, B. M. & Boudreaux, E. D. (2007). The emergency department for routine healthcare: Race/ethnicity, socioeconomic status, and perceptual factors. Journal of Emergency Medicine, 32(2), 149 158. 6.) Machlin, S. R. (2006). Expenses for a hospital emergency room visit. Agency for Healthcare Research and Quality, 111. Retrieved June 11, 2008 from http://www.meps.ahrq.gov/mepsweb/data_files/publications/st111/stat111.pdfhttp://www.meps.ahrq.gov/mepsweb/data_files/publications/st111/stat111.pdf. 7.) Mayer, G. G., Villaire, M. & Connell, J. (2005). Ten recommendations for reducing unnecessary emergency department visits. Journal of Nursing Administration, 35(10), 428-430. 8.) Nadkarni, M. M. & Philbrick, J. T. (2005). Free clinics: A national survey. American Journal of the Medical Sciences, 330(1), 25-31. 9.) Nawar, E. W., Niska, R.W. & Xu, J. (2007). National hospital ambulatory medical care survey: 2005 emergency department summary advance data from vital and health statistics. National Center for Health Statistics, 386.Retrieved June 11, 2008 from http://www.cdc.gov/NCHS/data/ad/ad386.pdf.http://www.cdc.gov/NCHS/data/ad/ad386.pdf 10.) Oster, A. & Bindman, A. B. (2003). Emergency department visits for ambulatory care sensitive conditions: Insights into preventable hospitalizations. Medical Care, 41(2), 198-207. 11.) SoRelle, R. (2006). Medicaid cuts could burden ED's with more uninsured patients. Emergency Medicine News, 28(5), 133-134.1 12.) Williams, D. R. & Jackson, P. B. (2005). Social sources of racial disparities in health. Health Affairs, 24, 325-334. 13.) Zlotnick, C. (2006). Community-versus individual-level indicators to identify pediatric health care needs. Journal of Urban Health, 84, 45-59. 14.) Champaign County Census Data from US Census Buraeu http://quickfacts.census.gov/qfd/states/17/17019.html http://quickfacts.census.gov/qfd/states/17/17019.html

26. Compiled by Jennifer Byelick (2008)