The purpose of this study was to determine whether a coordinated and comprehensive system of care for the uninsured changed the behavior of the uninsured by decreasing non-urgent utilization of the emergency departments within a large, urban county. The literature on emergency department trends and interventions designed to decrease "inappropriate" or non-urgent use of the emergency departments was reviewed and links to relevant theoretical concepts were identified. Utilization data from six emergency departments and six federally qualified health centers were evaluated. Secondary data over a three-year time period were abstracted from patient and organizational records at the hospitals and federally qualified health centers. The utilization data from the emergency departments and health centers were compared. The analysis revealed a significant change in the number of non-urgent visits by self-pay patients at the emergency departments when the health centers expanded. A 32.2 percent decrease in utilization of the emergency departments by self-pay patients was found. Non-parametric tests demonstrated significant differences in the population seen at the emergency departments and the clinics over the three-year study period. Regression analysis demonstrated a statistically significant decrease in non-urgent, self-pay visits at the emergency departments as a result of the increase in self-pay visits at the federally qualified health centers. Further analysis includes forecasting the impact of future federally qualified health centers on emergency department utilization. Recommendations for future research include evaluation of the increased numbers of non-urgent transports from the local emergency medical system by self-pay patients as well as the design of a pilot study to look at the effectiveness of transporting these patients to the federally qualified health centers for care instead of to the local emergency departments.
| Identifer | oai:union.ndltd.org:ucf.edu/oai:stars.library.ucf.edu:etd-1407 |
| Date | 01 January 2005 |
| Creators | van Caulil, Karen Karen |
| Publisher | STARS |
| Source Sets | University of Central Florida |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Electronic Theses and Dissertations |
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