Journal of Community Health

, Volume 39, Issue 1, pp 108–117 | Cite as

Access to Care Outcomes: A Telephone Interview Study of a Suburban Safety Net Program for the Uninsured

  • Joe Feinglass
  • Narissa J. Nonzee
  • Kara R. Murphy
  • Richard Endress
  • Melissa A. Simon
Original Paper

Abstract

Access DuPage (AD) currently provides primary care for about 14,000 low income, uninsured residents of suburban DuPage County, IL, an area with a very limited healthcare safety net infrastructure. A telephone interview survey evaluated health care utilization, satisfaction, and health status outcomes and compared recent enrollees to individuals in the program for at least 1 year. Sequential new AD enrollees (n = 158) were asked about the previous year when uninsured, while randomly selected established AD enrollees (n = 135) were asked the same questions about the previous year when actively enrolled in AD. Established enrollees reported being more likely to get ‘any kind of tests or treatment’ (96.3 vs. 46.2 %, p < 0.0001), fewer cost (78.5 vs. 21.3 %, p < 0.0001) and transportation barriers to care, more preventive and mental health services, and better self-management care. However, established enrollees also reported 14 % greater use of hospital inpatient and 9 % greater use of emergency room care, as well as continued difficulty in accessing needed specialty and dental care services. Despite more (diagnosed) conditions, established enrollees were over 2.5 times more likely to report good to excellent health status and over three times more likely to rate their satisfaction with health care as good to excellent. Findings illustrate the substantial benefits of assuring access to care for the uninsured, but do not reflect immediate savings from reduced hospital utilization. Access to care programs will be an important tool to address the needs of the 30 million people who will continue to be uninsured in the United States.

Keywords

Access to care Safety net Uninsured Health care reform 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Joe Feinglass
    • 1
  • Narissa J. Nonzee
    • 2
    • 3
  • Kara R. Murphy
    • 4
  • Richard Endress
    • 4
  • Melissa A. Simon
    • 5
    • 6
    • 7
  1. 1.Department of Medicine, Division of General Internal MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Institute for Public Health and MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  3. 3.Robert H. Lurie Comprehensive Cancer Center of Northwestern UniversityChicagoUSA
  4. 4.Access DuPageCarol StreamUSA
  5. 5.Department of Obstetrics and GynecologyNorthwestern University Feinberg School of MedicineChicagoUSA
  6. 6.Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  7. 7.Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoUSA

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