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Factors Influencing Healthcare Utilization Among Patients at Three Free Clinics

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Abstract

Despite improvements in healthcare for uninsured persons, health disparities remain. We surveyed patients at three free clinics in an urban Florida community to better understand the factors that influence where they seek healthcare. Survey questions were developed based on factors previously demonstrated to affect healthcare utilization. A focus group validated the instrument. Patients self-administered written surveys over a 6-week period at three free clinics, including a student-run free clinic (SRFC). Results were compiled and analyzed using Chi-square and Fisher–Freeman–Halton Exact tests, Kruskal–Wallis test, Mann–Whitney U test, and Spearman’s rho, as appropriate. Odds ratios were calculated for significant findings (p < 0.05). Patients completed 323 surveys. Free clinic visit frequency was positively related to female gender, Hispanic ethnicity, higher income, and poorer health. Black race was related to less frequent visits. Visit frequency differed among the clinic sites. Patients attending a SRFC were more likely to utilize another clinic. Patient satisfaction was not related to visit frequency. Seeking care at other clinics was related to employment. Emergency room utilization was positively related to male gender. Patients listed proximity and ability to receive care not offered at the free clinic as the primary reasons for seeking care at another clinic. In this sample, free clinic utilization was related to demographic and community factors. Free clinics should consider these factors when designing their care delivery. SRFC’s should further evaluate how they function in the safety net.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon request. Data is summarized in attached tables and text.

Code Availability

Not applicable.

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Acknowledgements

The authors wish to acknowledge the patients and staff of the free clinics participating in this study, as well as statistical support provided by the University of South Florida Morsani College of Medicine Office of Research. No financial support was provided.

Funding

This research was not funded.

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Authors and Affiliations

  1. Department of Family Medicine, University of South Florida Morsani College of Medicine, 13330 USF Laurel Drive, Tampa, FL, 33612, USA

    J. Petrilli & J. Costa

  2. University of South Florida Morsani College of Medicine, Tampa, USA

    L. Strang & E. Von Haunalter

  3. Department of Medical Education, University of South Florida Morsani College of Medicine, Tampa, USA

    E. Coughlin

  4. Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA

    R. Mhaskar

Authors
  1. J. Petrilli
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  2. L. Strang
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  4. J. Costa
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  5. E. Coughlin
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  6. R. Mhaskar
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Contributions

Conceptualization: JP. IRB: JP. Methodology: JP, RM, EC, JC. Data Collection: LS, EH, BW (not an author). Statistical analysis: EC, RM. Writing—original draft preparation: JP, LS. Writing—review and editing: JP, LS, JC, EH, EC. All authors read and approved submission of the final article.

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Correspondence to J. Petrilli.

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Conflict of interest

None of the authors have any conflicts to disclose.

Ethical Approval

The University of South Florida’s IRB reviewed this project and granted it an “exempt” status prior to study initiation.

Consent to Participate

All patients consented to participate in this survey-based study. No identifiable information was collected. Consent form available upon request.

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Not applicable.

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Petrilli, J., Strang, L., Von Haunalter, E. et al. Factors Influencing Healthcare Utilization Among Patients at Three Free Clinics. J Community Health 47, 604–609 (2022). https://doi.org/10.1007/s10900-022-01083-7

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