Emergency department and community health center visits and costs in an uninsured population

Purpose: To assess how a Community Health Center (CHC) influenced access to care for uninsured people and to describe the economic effect on the local hospital. Design: A framework on access to health care was used in this community-level, descriptive study. Methods: Data were collected on emergency department (ED) use before state funding of the CHC, 1988 and through 2001. Information included insurance status, charges, diagnosis, and complexity of services received. This study is a population study, and descriptive statistics were used to analyze the data. Findings: Within 3 years after state funding of a CHC began, uninsured visits to the local hospital ED decreased by almost 40%. After 10 years, uninsured ED visits remained 25% lower than before state funding began, whereas insured visits had almost doubled (98%). The decrease in number of uninsured visits saved the hospital and uninsured patients almost $14 million. Conclusions: After establishment of the CHC, ED visits by uninsured patients declined. Although a causal link cannot be made between the CHC and ED, the descriptive data provide information about a linkage between the decline of uninsured ED visits and the CHC.