The Effect of a Student-Run Free Clinic on Hospital Utilization

被引:20
作者
Trumbo, Silas P. [1 ]
Schuering, Kelly M. [2 ]
Kallos, Justiss A. [3 ]
Baddour, Nicolas [2 ]
Rakhit, Shayan [2 ]
Wang, Li [1 ]
Fowler, Michael [4 ,5 ]
Vasilevskis, Eduard E. [4 ,6 ]
Miller, Robert F. [5 ,7 ]
机构
[1] Vanderbilt Univ, Med Ctr, Nashville, TN 37232 USA
[2] Vanderbilt Univ, Sch Med, Nashville, TN 37232 USA
[3] Univ Pittsburgh, Med Ctr, Neurosurg, Pittsburgh, PA 15260 USA
[4] Vanderbilt Univ, Med Ctr, Med, Nashville, TN 37232 USA
[5] Shade Tree Clin, Nashville, TN USA
[6] VA Tennessee Valley, Geriatr Res Educ & Clin Ctr, Nashville, VA USA
[7] Vanderbilt Univ, Med Ctr, Clin Med, Nashville, TN 37232 USA
关键词
Student-run free clinics; hospital utilization; underserved populations; medical education; patient-centered care; HEALTH; CARE; OUTCOMES;
D O I
10.1353/hpu.2018.0053
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Student-run free clinics (SRFCs) serve uninsured patients and offer unique educational opportunities. However, the impact of these clinics on hospital utilization is unclear. In this pre-post observational study, we used multivariable modeling to test the hypothesis that patients of Shade Tree Clinic, the SRFC affiliated with Vanderbilt University Medical Center (VUMC), would have decreased hospital utilization after joining the clinic. To evaluate the relationship between STC and VUMC, we conducted a sub-analysis of patients referred to Shade Tree from VUMC using univariate Wilcoxon signed-rank tests. Multivariable analysis showed patients were less likely to be hospitalized after joining Shade Tree (p=.04). Univariate analysis showed differences in hospitalizations among patients referred from VUMC (p=.02). These results suggest that Shade Tree does not result in an additional burden on the health care system and may reduce hospital utilization. Additional research with control populations may further highlight the effect of SRFCs on health care utilization.
引用
收藏
页码:701 / 710
页数:10
相关论文
共 19 条
[11]   Presence and Characteristics of Student-Run Free Clinics in Medical Schools [J].
Smith, Sunny ;
Thomas, Robert, III ;
Cruz, Michael ;
Griggs, Ryan ;
Moscato, Brittany ;
Ferrara, Ashley .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2014, 312 (22) :2407-2410
[12]   Changes in Self-reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act [J].
Sommers, Benjamin D. ;
Gunja, Munira Z. ;
Finegold, Kenneth ;
Musco, Thomas .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2015, 314 (04) :366-374
[13]  
Steiner CA, 2013, PREV CHRONIC DIS, V10, DOI [10.5888/pcd10.120292e, 10.5888/pcd10.120292]
[14]  
Taylor MA, 2016, FAM MED, V48, P127
[15]  
Tennessee Hospital Association (THA), 2015, THA HLTH INF NETW
[16]  
Uscher-Pines L, 2013, AM J MANAG CARE, V19, P47
[17]   Assessment of Hypertension Management and Outcomes at an Indianapolis Student-Run Free Clinic [J].
Wahle, Benjamin ;
Meyer, Kathryn ;
Faller, Meredith ;
Kochhar, Komal ;
Sevilla, Javier .
JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED, 2017, 28 (02) :694-706
[18]   Measuring and Assessing Preventive Medicine Services in a Student-Run Free Clinic [J].
Zucker, Jason ;
Lee, Janet ;
Khokhar, Mamoona ;
Schroeder, Robin ;
Keller, Steven .
JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED, 2013, 24 (01) :344-358
[19]   Hypertension Management in a Student-Run Free Clinic: Meeting National Standards? [J].
Zucker, Jason ;
Gillen, Jennifer ;
Ackrivo, Jason ;
Schroeder, Robin ;
Keller, Steven .
ACADEMIC MEDICINE, 2011, 86 (02) :239-245