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Student Faculty Collaborative Clinics Influence on Emergency Department Use

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Abstract

Student-faculty collaborative clinics, like the Crimson Care Collaborative (CCC), provide primary care access to underserved communities. Affiliated with a community health center, CCC-Chelsea serves a largely immigrant and refugee population. This study aimed to analyze patients’ reported ED use before and after they presented to CCC-Chelsea and whether types of insurance affect ED use. We prospectively surveyed 229 patients presenting to CCC-Chelsea between 2013 and 2019. Patients who presented for two or more visits at least one year apart were included in the study. A two-sided Wilcoxon signed rank test was used to compare reported ED use before and after presenting to CCC-Chelsea, and a Kruskal–Wallis test analyzed the association between ED use and insurance status. Most patients (77.7%) presenting to CCC-Chelsea identified as Hispanic, 70.9% were male, 50.6% of patients reported an income of less than $15,000 yearly, and 30.4% had an income between $15,000–$30,000. Most patients (51.9%) did not specify the type of insurance used, followed by public insurance (36.7%), with the remaining having private or no insurance. Results from our survey showed that patients who returned to CCC-Chelsea reported a decrease in the average number of yearly ED visits after attending CCC-Chelsea (pre-CCC 1.544, post-CCC 0.696, p < 0.001 at the 95% CI). There was no difference in reported average number of ED visits yearly and insurance type (p = 0.579). Patients’ reported ED utilization after accessing care at CCC-Chelsea decreased. Increased access to student-faculty collaborative clinics could reduce ED use in underserved populations.

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Abbreviations

CCC:

Crimson Care Collaborative

ED:

Emergency Department

CI:

Confidence Interval

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Acknowledgements

The John D. Stoeckle Center for Primary Care Innovation, located at the Massachusetts General Hospital, has been generously supporting the Crimson Care Collaborative. Statistical consultations were provided by Harvard Catalyst and statistical tests were run by Jane Rhee. This project was funded by the Harvard College Research program.

Funding

The John D. Stoeckle Center for Primary Care Innovation, located at the Massachusetts General Hospital, has been generously supporting the Crimson Care Collaborative. This project was funded by the Harvard College Research program.

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Authors and Affiliations

  1. Harvard College, Cambridge, MA, USA

    Rewan Abdelwahab

  2. Crimson Care Collaborative, Boston, MA, USA

    Rewan Abdelwahab, Sarah Abdelwahab, Mie Hallman, Gina Kruse, Jacqueline T. Chu & Marya J. Cohen

  3. Faculty of Medicine, University of Alexandria, Alexandria, Egypt

    Sarah Abdelwahab

  4. Harvard Medical School, Boston, MA, USA

    Gina Kruse, Jacqueline T. Chu & Marya J. Cohen

  5. Massachusetts General Hospital, 165 Cambridge St, Boston, MA, 02115, USA

    Mie Hallman, Gina Kruse, Jacqueline T. Chu & Marya J. Cohen

Authors
  1. Rewan Abdelwahab
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  2. Sarah Abdelwahab
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  4. Gina Kruse
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Correspondence to Marya J. Cohen.

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Abdelwahab, R., Abdelwahab, S., Hallman, M. et al. Student Faculty Collaborative Clinics Influence on Emergency Department Use. J Community Health 48, 18–23 (2023). https://doi.org/10.1007/s10900-022-01138-9

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