Health Clinics are Helpful

Free clinic treatment can save costs and reduce unnecessary ER visits

February 13, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) The ER is the first place patients often think of going when there's a dire need for medical attention. But not all emergencies call for that level of care. Using free medical clinics may do the trick.

Seeking care at free medical clinics can reduce the number of unnecessary visits to the emergency room, according to a recently published study.

Free clinics can help fill the void in providing care to patients with low-level health concerns that do not need the attention of more costly emergency care at hospitals.

"Find free health clinics in your area at www.freeclinicdirectory.org."

The study, led by Wenke Hwang, PhD, from the Penn State University College of Medicine, Public Health Sciences, included five hospitals that were part of Hospital Corporation of American and four free clinics in three Virginia communities.

Researchers identified uninsured patients who sought treatment at free clinics and hospital emergency rooms between March 2004 and February 2006. 

More than 52,000 individual patients were identified and made up nearly 100,000 emergency room visits. About 1 out of 10 hospital visits were by patients who sought care at a clinic as well.

Researchers focused on the level of care provided by hospitals and the decision-making process within each of the ER visits, as categorized by the Hospital Corporation of America's standards.

They also tracked whether emergency treatments were needed in each case or if ambulatory care was sufficient.

Researchers found that patients who visited clinics and the ER together were more likely to be female, white and older with a pre-existing chronic disease, such as diabetes, chronic obstructive pulmonary disease or hypertension.

Young adults between 18 and 24 years of age were significantly more likely to visit the ER for low-level care needs that may have been avoidable, researchers found.

More than 70 percent of patients who visited clinics were under 45 years of age, compared to 84 percent of patients who did not visit clinics.

According to researchers, patients who sought care at clinics before visiting emergency departments were less likely to need lower levels of care, which means that clinic users were less likely to use the ER as their first source for care.

"This suggests that by serving as medical homes for the uninsured, [clinics] can help reduce simple, low complexity types of [emergency department] visits," researchers wrote in their report.

The use of clinics is more cost effective than getting care from emergency departments, the researchers said. Clinics are also in a position to expand their services to address health needs that require more attention.

"Thus, hospitals that work with local [free clinics] not only provide an important charitable function, but also may benefit financially by diverting unnecessary and costly emergency department visits," researchers wrote.

The results should be depicted with caution, according to Adam Powell, PhD, a dailyRx Contributing Expert and president of Payer+Provider Syndicate, a consulting firm for economic and health services research.

"While it is safe to generally assume that treating patients in 'free' outpatient clinics costs the healthcare system less than providing equivalent uncompensated care in an emergency room setting, the results of this study should be interpreted with caution and do not directly demonstrate any savings," Dr. Powell said. 

Researchers noted several limitations to their study, including their inability to determine whether care provided at an ER would be beneficial enough for patients who did not go to the clinics.

The researchers also assumed that uninsured patients who did not seek care at clinics were likelier to have chronic conditions that went undiagnosed during the study.

In addition, the researchers assumed that the clinic would be the primary place patients would get care, particularly in medical areas where clinics are more available. These limitations may have skewed their results.

The study was published recently in the Journal of Health Care for the Poor and Underserved. The Hospital Corporate of America funded the research.

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Review Date: 
January 29, 2013
Last Updated:
March 8, 2013