Journal of Health Care for the Poor and Underserved
Volume 30, Issue 2, 2019, Pages 806-819

Four years of CHEER: Cost and QALY savings of a free nurse-run walk-in clinic serving an uninsured, predominantly spanish-speaking immigrant population in providence (Article)

Barry K. , McCarthy M. , Buckley J. , Jacques S. , Johnson H. , Almeida-Monroe V. , De Groot A.S.*
  • a Clínica Esperanza/Hope Clinic, United States
  • b Clínica Esperanza/Hope Clinic, United States
  • c Clínica Esperanza/Hope Clinic, United States
  • d Clínica Esperanza/Hope Clinic, United States
  • e Dartmouth College, Geisel School of Medicine, Clínica Esperanza/Hope Clinic, United States
  • f Clínica Esperanza/Hope Clinic, United States
  • g Clínica Esperanza/ Hope Clinic, CEO/CSO, EpiVax, Inc, United States, Institute for Immunology and Informatics, University of Rhode Island, United States

Abstract

Non-emergent visits to emergency departments by uninsured patients impose unnecessary costs on both patients and safety-net institutions. We evaluated the health and economic impacts of providing free, walk-in care to low-income, uninsured adults-most of them Hispanic-at a free clinic between January 2013 and December 2016. Providing access to health care services for uninsured patients at Clínica Esperanza/ Hope Clinic reduced emergency department expenditures in Rhode Island by approximately $448,876 (range: $410,377-$487,375) annually and may have also reduced future healthcare costs for this population by more than $48 million ($12,034,469 annually) over the four-year evaluation period. For every $1 in funding for walk-in clinic operation, delivering free care provided a return on investment of $71.18 (range: $70.95-71.40) in healthcare value. Providing access to non-emergent walk-in care at the more than 12,000 free healthcare clinics nationwide may save billions in ED costs while improving the health of uninsured individuals. © Meharry Medical College.

Author Keywords

Cost-benefit analysis Emergency room diversion Models Medically uninsured nursing health equity Healthcare disparities

Index Keywords

human immigrant Rhode Island medically uninsured emergency ward lowest income group quality adjusted life year funding nurse Cost benefit analysis health equity Article speech health care disparity investment adult Hispanic
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85066945637&doi=10.1353%2fhpu.2019.0057&partnerID=40&md5=2a0f6b0995912a72ee5e63b3194622a9
DOI: 10.1353/hpu.2019.0057
ISSN: 10492089
Original Language: English