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The influence of free clinic service...

Hoffman, Richard N.

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The influence of free clinic services on hospital resource utilization for preventable hospitalizations of the medically indigent in rural New York state.

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	The influence of free clinic services on hospital resource utilization for preventable hospitalizations of the medically indigent in rural New York state./
作者:	Hoffman, Richard N.
面頁冊數:	224 p.
附註:	Source: Dissertation Abstracts International, Volume: 72-06, Section: B, page: .
Contained By:	Dissertation Abstracts International72-06B.
標題:	Health Sciences, General. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3451202
ISBN:	9781124562445

The influence of free clinic services on hospital resource utilization for preventable hospitalizations of the medically indigent in rural New York state.
Hoffman, Richard N.

The influence of free clinic services on hospital resource utilization for preventable hospitalizations of the medically indigent in rural New York state. - 224 p.

Source: Dissertation Abstracts International, Volume: 72-06, Section: B, page: .

Thesis (Ph.D.)--TUI University, 2011.

Free clinics have been proposed as a viable option to strengthen the rural healthcare safety net for the medically indigent because access to primary care can improve health status and reduce preventable hospitalizations. However, research relevant to the efficacy of free clinics is limited. This study examined the influence of free clinic services on hospital resource utilization in rural counties of New York State, and identified a model of free clinic attributes that predict optimal utilization of hospital resources by the medically indigent.

ISBN: 9781124562445Subjects--Topical Terms:

1017817
Health Sciences, General.

The influence of free clinic services on hospital resource utilization for preventable hospitalizations of the medically indigent in rural New York state.
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245 1 4 $a The influence of free clinic services on hospital resource utilization for preventable hospitalizations of the medically indigent in rural New York state.
300 $a 224 p.
500 $a Source: Dissertation Abstracts International, Volume: 72-06, Section: B, page: .
500 $a Adviser: Angela Hegamin.
502 $a Thesis (Ph.D.)--TUI University, 2011.
520 $a Free clinics have been proposed as a viable option to strengthen the rural healthcare safety net for the medically indigent because access to primary care can improve health status and reduce preventable hospitalizations. However, research relevant to the efficacy of free clinics is limited. This study examined the influence of free clinic services on hospital resource utilization in rural counties of New York State, and identified a model of free clinic attributes that predict optimal utilization of hospital resources by the medically indigent.
520 $a This retrospective observational study was conducted in two phases. Phase I employed a Regression Point Displacement strategy using Multiple Regression and ANCOVA to ascertain the relationship between free clinics and hospital resource utilization by the medically indigent as measured by charges per day for Ambulatory Care Sensitive Hospitalizations (ACSH). Phase II employed Multiple Regression to identify a model of free clinic attributes that predicts optimal hospital resource utilization across Ambulatory, Chronic and Preventable categories of ACSH. Hospital discharge data from 1996 and 2007 was obtained from the New York Statewide Planning and Research Cooperative System. Free Clinic data was obtained from a survey of free clinics conducted by Darnell (2008).
520 $a A significant relationship was found between free clinics and a reduction in hospital resource utilization by the medically indigent at the individual patient discharge-level (p < .001), however, when aggregated at the hospital-level, free clinics appeared to have no relationship with hospital resource utilization (p = ns). Phase II results supported a model of core primary care attributes that predicts optimal utilization of hospital resources (p < .001), however the model did not appear to provide consistent benefits across the three categories of ACSH (p = ns).
520 $a The results of this study provides policy makers and healthcare providers with valuable insight into the role free clinics can play in strengthening the healthcare safety net at the individual patient level. Further, the results support the potential of delivery models that encourage the medically indigent to effectively access primary care, ultimately reducing their future risk of disease, and perhaps reducing the financial burden on hospitals in rural communities.
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