About the CCCHC “Champaign County Christian Health Center is a not for profit health center founded in 2003. Our mission is to show and share the love

About the CCCHC“Champaign County Christian Health Center is a not for profit health center founded in 2003. Our mission is to show and share the love of Jesus Christ to our neighbors of Champaign County by providing holistic, free, and quality health care services.”

507 S. Second St.Suite 2EChampaign, IL [email protected]

http://www.ccchc2003.org

About the CCCHCProvides:

primary care immunizationsphysicalsscreeningseducational eventsprayer and support

ProblemA large population of uninsured and

underinsuredLimited access to healthcareOver-utilization of Emergency

Department (ED)Objectives

Assess the clients of the Champaign County Christian Health CenterDemographic CharacteristicsHealth Service Utilization

Problem & Objectives

MethodologySelf-reported client surveys completed before receiving services from the Champaign County Christian Health Center (CCCHC)Ten optional questions that included

demographic information and health service utilization

English and Spanish translations provided970 cases reviewed

Secondary data analysis using (SPSS) Statistical Package for the Social Sciences

Scholarly literature review of free health clinic clientele

75% of patients uninsuredOver half lived within 200% of

federal poverty levelMinorities make up 60% of the

uninsured American populationMinority populations face:

lower quality of health carelack access to care

Williams, David R and Jackson, Pamela Braboy Social Sources of Racial Disparities in Health, (2005, March/April), Health Affairs Vol. 24(2) Nadkarni, M. M. & Philbrick, J. T. (2005). Free clinics: A national survey. American Journal of the Medical Sciences, 330(1), 25-31.

45.2

74.9

29.6

11.4 9.2 8.1 11.94.0 4.1 1.6

020406080

Per

cent

of

Pati

ents

White B lac k As ian H is panic Other

R ac e / E thnic ity

R ac e/E thnic ity of C linic vs . C ounty R es idents ***% C linic

% C ha mpa ig nP opula tion

*** p< .001

http://quickfacts.census.gov/gfd/states/17/17019.html

1.2

5.93.7

10.8

19.2

26.3

41.8

26.8

32.5

20.3

1.1

4.9

0.41.40

5

10

15

20

25

30

35

40

45

Percent

Under 5 5 to 14 15-24 25-44 45-64 65-74 75 andolder

Age

Age of Clinic vs. County Residents***

% Clinic

% Champaign County

*** p<.001


*

Female Headed Households of Clinic vs. County Residents

45.6%

8.9%

0

5

10

15

20

25

30

35

40

45

50%

Fem

ale

Hea

ded

Ho

use

ho

lds

CCCHC Champaign *p<.05

*


Alternative Sources of Health Care to Clinic***

13.0 13.7 15.1

2.2 2.0 0.5

23.225.9

3.30.8

0

5

10

15

20

25

30

Hospital

ED Comm

unity Health Centers

Public Health Department

Private Physician

Outside County/State/City

Nowhere

Don’t Know

Other

Unreadable answer

Source of Care

Per

cen

t

*** p<.001

Average National Emergency Department Utilization StatisticsIn 2005, 115.3 million visits to ED’s

(39.6 visits per 100 people).

An average of 30,000 visits per ED, a 31% increase from 1995.

41.9 million injury-related ED visits (14.4 visits per 100 people)

Nawar EW, Niska RW, Xu J ( 2007) National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital and health statistics; no. 386. National Center for Health Statisticshttp://www.cdc.gov/nchs/data/ad/ad396.pdf

Costs of ED Visits

In 2003, average expenditure for an ED visit was $560

Average of $121 for an office-based visit

Highest average ED expense for ages 45–64 at $832

ED expenses were slightly higher for males than for females

Emergency Department Visits in the Past Year per Person: CCCHC vs. National

0.396

1.04

0

0.2

0.4

0.6

0.8

1

1.2

Nu

mb

er

of

ED

Vis

its

pe

r P

ers

on

CCCHC Patient National


Scholarly literature findings on emergency department utilization among uninsured

25% patients visiting ED’s as primary source of health care

15-25% using ED as only source of care

Strongest indicator of ED use is insurance statusHong, Rick, Baumann, Brigitte M. and Boudreaux, Edwin D ( 2007) The emergency department for

routine healthcare: Race/ethnicity, socioeconomic status, and perceptual factors [Electronic Version] Journal of Emergency Medicine Vol. 32, Issue 2, pp 149-158

Frequency of ED Visits by CCCHC Patients***

558

14783

44 19 44 75

0

100

200

300

400

500

600

0 times 1 time 2 times 3 times 4 times 5 ormoretimes

Missing

Number of ED Visits in past year

Fre

qu

ency

*** P<.001

0

20

40

60

80

100

Fre

qu

ency

Condition

Reasons for CCCHC Patient's ED Visits***

*632 cases N/A, did not visit ED within last year

*** p<.001

Top Patient Reasons for Emergency Department Visit

CCCHC Patients Average National ED Patients in 2005

1. Injury 1. Stomach/Abdominal Pain

2. Gastric Symptoms 2. Chest Pain

3. Blood Pressure/ Problems 3. Fever

4. Cardiac Symptoms 4. Cough

5. Mental Health Conditions 5. Headache, pain in head


Urgency of ED Conditions: National vs. CCCHC Urgency of Condition for National ED Visits

48.6%

34.6%

16.7%

Urgency of Condition for CCCHC ED Visit

30.8%

69.2%

Non-urgent

Urgent

Non-urgent

Urgent

Unknown

***p<.001

***


37.246.1

62.853.9

0

10

20

30

40

50

60

70

Percent ED Visits

Male Female

Gender

Total ED Visits by Gender: CCCHC vs. National Averages*

% Clinic ED Visits

% National ED Visits

*p<.05


*N/A

*N/A

45.2

74.7

40.7

21.9

1.4 1.1 2.7 4.1 1.50

20

40

60

80

Per

cen

t of

ED

Vis

its

White B la c k Asia n Hispa nic Other

R ac e / E thnic ity

P erc ent of E D Vis its by R ac e: C C C HC vs . National Averag es **

% C linic E D Visits

% Na tiona l E D Visits

* Unable to c om pare s inc e His panic is re g arde d as e thnic ity rathe r than rac e in national data

**p< .01

*N/A


Average ED Visit per Female Head of Household*

1.25

0.87

0

0.5

1

1.5

Yes No

Female Head of Household

Nu

mb

er

ED

Vis

its

in

Pa

st

Ye

ar

*p<.0

0.95

11.2

3.3

10.0

19.716.2

41.6

28.832.7

19.2

1.2

5.9

0.48

8.6

0

5

10

15

20

25

30

35

40

45

Percent ED Visits

Under 5 5 to 14 15-24 25-44 45-64 65-74 75 andolder

Age

Percent of Total ED Visits by Age: CCCHC vs. National Average

% Clinic ED Visits

% National ED Visits


LimitationsSelf-reported data

Difficulties in interpretationSurveys were not completed by all clients

Surveys were collected over a two year period without date-stamping

ConclusionsHigh rate of minority, female head of

household, and patients ages 25-64 using the free clinic

CCCHC patients followed national ED utilization trends among uninsured

Implications for ED overcrowding

1.) Cardarelli, R. & Chiapa, A. (2007). Educating primary care clinicians about health disparities. Osteopathic Medicine and Primary Care, 1(5). Retrieved June 9, 2008 fromhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1808470. 2.) Cheong, P. H., Feeley, T. H. & Servoss, T. (2007). Understanding health inequalities for uninsured Americans: A population-wide survey. Journal of Health Communication, 12(3), 285-300.3.) Davidson, R. A., Guancola, A., Gast, A., Ho, J. & Waddell, R. (2003). Evaluation of access, a primary care program for indigent patients: Inpatient and emergency room utilization. Journal of Community Health, 28, 59-64.4.) Diesburg-Stanwood, A., Scott, J., Oman, K. & Whitehill, C. (2004). Nonemergent ED patients referred to community resources after medical screening examination: Characteristics, medical condition after 72

hours,and use of follow-up services. Journal of Emergency Nursing, 30(4), 312-317.5.) Hong, R., Baumann, B. M. & Boudreaux, E. D. (2007). The emergency department for routine healthcare: Race/ethnicity, socioeconomic status, and perceptual factors. Journal of Emergency Medicine, 32(2), 149158. 6.) Machlin, S. R. (2006). Expenses for a hospital emergency room visit. Agency for Healthcare Research and Quality, 111. Retrieved June 11, 2008 fromhttp://www.meps.ahrq.gov/mepsweb/data_files/publications/st111/stat111.pdf.7.) Mayer, G. G., Villaire, M. & Connell, J. (2005). Ten recommendations for reducing unnecessary emergency department visits. Journal of Nursing Administration, 35(10), 428-430.8.) Nadkarni, M. M. & Philbrick, J. T. (2005). Free clinics: A national survey. American Journal of the Medical Sciences, 330(1), 25-31. 9.) Nawar, E. W., Niska, R.W. & Xu, J. (2007). National hospital ambulatory medical care survey: 2005 emergency department summary advance data from vital and health statistics. National Center for HealthStatistics, 386.Retrieved June 11, 2008 from http://www.cdc.gov/NCHS/data/ad/ad386.pdf. 10.) Oster, A. & Bindman, A. B. (2003). Emergency department visits for ambulatory care sensitive conditions: Insights into preventable hospitalizations. Medical Care, 41(2), 198-207.11.) SoRelle, R. (2006). Medicaid cuts could burden ED's with more uninsured patients. Emergency Medicine News, 28(5), 133-134.112.) Williams, D. R. & Jackson, P. B. (2005). Social sources of racial disparities in health. Health Affairs, 24, 325-334.13.) Zlotnick, C. (2006). Community-versus individual-level indicators to identify pediatric health care needs. Journal of Urban Health, 84, 45-59.14.) Champaign County Census Data from US Census Buraeu http://quickfacts.census.gov/qfd/states/17/17019.html

Compiled by Jennifer Byelick (2008)

Documents

About the CCCHC “Champaign County Christian Health Center is a not for profit health center founded in 2003. Our mission is to show and share the love