TY - JOUR
T1 - Identifying patient, community and program specific barriers to free specialty care utilization by uninsured patients in East Baltimore
AU - Handy, Catherine
AU - Ma, Sai
AU - Block, Lauren
AU - de la Torre, Desiree
AU - Langley, Anne
AU - Cook, Barbara
PY - 2013/5
Y1 - 2013/5
N2 - Uninsured individuals face multiple barriers to accessing specialty care. The Access Partnership (TAP) offers free specialty care and care coordination to qualified uninsured patients at an urban academic medical center for a small program entry fee (waived for financial hardship). In the program's first year, 104 eligible patients (31%) did not enroll. To understand why, we investigated demographic, referral, personal, and program-specific factors. After adjusting for age, gender, and ZIP code, diagnostic and therapeutic referrals were more likely to be completed than ancillary referrals (OR=8.56, p=.001; OR 3.53, p=.03). There was no difference between pain related and ancillary referrals (OR=2.80, p=.139). Eighteen patients were surveyed and reported program and patient-specific barriers. While removing costs is necessary to improve access to specialty care for underserved patients, it is insufficient. Improving communication from program coordinators and enrollment strategies may help to improve utilization of free care programs by the uninsured.
AB - Uninsured individuals face multiple barriers to accessing specialty care. The Access Partnership (TAP) offers free specialty care and care coordination to qualified uninsured patients at an urban academic medical center for a small program entry fee (waived for financial hardship). In the program's first year, 104 eligible patients (31%) did not enroll. To understand why, we investigated demographic, referral, personal, and program-specific factors. After adjusting for age, gender, and ZIP code, diagnostic and therapeutic referrals were more likely to be completed than ancillary referrals (OR=8.56, p=.001; OR 3.53, p=.03). There was no difference between pain related and ancillary referrals (OR=2.80, p=.139). Eighteen patients were surveyed and reported program and patient-specific barriers. While removing costs is necessary to improve access to specialty care for underserved patients, it is insufficient. Improving communication from program coordinators and enrollment strategies may help to improve utilization of free care programs by the uninsured.
KW - Academic medical center
KW - Access to health care
KW - Specialists
KW - Uninsured
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U2 - 10.1353/hpu.2013.0085
DO - 10.1353/hpu.2013.0085
M3 - Article
C2 - 23728036
AN - SCOPUS:84878445220
SN - 1049-2089
VL - 24
SP - 688
EP - 696
JO - Journal of health care for the poor and underserved
JF - Journal of health care for the poor and underserved
IS - 2
ER -