Grant watch report: Is there a (volunteer) doctor in the house? Free clinics and volunteer physician referral networks in the united states

Health Affairs

Volumn 26, Issue 3, 2007, Pages 871-876

  Isaacs, Stephen L ^a   Jellinek, Paul ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMMUNITY CARE; HUMAN; MEDICINE; NONBIOLOGICAL MODEL; ORGANIZATION AND MANAGEMENT; PATIENT REFERRAL; PROFESSIONAL PRACTICE; STATISTICS; UNITED STATES; VOLUNTARY WORKER;

HUMANS; MODELS, ORGANIZATIONAL; PROFESSIONAL PRACTICE; REFERRAL AND CONSULTATION; SPECIALTIES, MEDICAL; UNCOMPENSATED CARE; UNITED STATES; VOLUNTARY WORKERS;

EID: 34248564905     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.26.3.871     Document Type: Review

References (27)

1. P.J. Cunningham and J.H. May, "A Growing Hole in the Safety Net: Physician Charity Care Declines Again," Health Tracking Report no. 13 (Washington: Center for Studying Health System Change, March 2006).
2. Authors' calculations based on data from Kaiser Commission on Medicaid and the Uninsured, "Covering the Uninsured: Growing Need, Strained Resources," Fact Sheet, January 2007, http://www.kff.org/uninsured/upload/ 7429-02.pdf (accessed 15 March 2007);
3. and Kaiser Commission, Medicaid Enrollment in Fifty States: June 2005 Data Update, December 2006, Figure 1, http://www.kff.org/medicaid/upload/ 7606.pdf (accessed 15 March 2007).
4. Ibid.
5. C.B. Forrest and E.M. Whelan, "Primary Care Safety-Net Delivery Sites in the United States: A Comparison of Community Health Centers, Hospital Outpatient Departments, and Physicians' Offices," Journal of the American Medical Association 284, no. 16 (2000): 2077-2083.
6. Authors' calculation derived from American Medical Association, Physician Characteristics and Distribution in the U.S.: 2007 Edition (Chicago: AMA, 2007).
7. G. Fairbrother et al., "Care for the Uninsured in General Internists' Private Offices," Health Affairs 22, no. 6 (2003): 217-224.
8. J. Hadley et al., Federal Spending on the Health Care Safety Net from 2001-2004: Has Spending Kept Pace with the Growth in the Uninsured? November 2005, http://www.kff.org/uninsured/7425.cfm (accessed 5 February 2007).
9. M.C. Reed, P.J. Cunningham, and J. Stoddard, "Physicians Pulling Back from Charity Care," Issue Brief no. 42 (Washington: HSC, August 2001).
10. See E. Salinsky, "Necessary but Not Sufficient? Physician Volunteerism and the Health Care Safety Net," Background Paper (Washington: National Health Policy Forum, 10 March 2004).
11. The twenty-one volunteer health care programs were located in California (Cotati, San Francisco, and Venice); Florida (Miami); Illinois (Chicago); Kansas (Wichita); Michigan (Coldwater, Grand Rapids, and Kalamazoo); Nebraska (Omaha); New Hampshire (Exeter); New Jersey (Red Bank); North Carolina (Asheville); Ohio (Cleveland and Lakewood); South Carolina (Hilton Head); Tennessee (Knoxville, Maryville, and Sevierville); West Virginia (Charleston); and Wisconsin (Racine).
12. Donald Weaver, assistant surgeon general and deputy associate administrator for primary health care, Health Resources and Services Administration, "HRSA's Health Center Program: Overview" (slides), personal communication, 21 March 2007;
13. authors' estimates of the number of public hospital patients based on information in O. Zaman, E. Lukens, and L. Cummings, America's Public Hospitals and Health Systems, 2004: Results of the Annual NAPH Hospital Characteristics Survey (Washington: National Association of Public Hospitals and Health Systems, 2006);
14. and American Hospital Association, "Uncompensated Hospital Care Cost Fact Sheet," October 2006, http://www.aha.org/aha/content/2006/pdf/ uncompensatedcarefs2006.pdf (accessed 12 February 2007). The nation's hospitals provided $28.8 billion in uncompensated care; the AHA did not state the number of patients this covered.
15. See the National Association of Free Clinics home page, http://www.freeclinics.us.
16. HRSA, Report to Congress: A Review of the Free Clinics Network (Rockville, Md.: HRSA, 2005).
17. Authors' estimate of the number of patients served is based on information provided in ibid.
18. Weaver, HRSA, "HRSA's Health Center Program"; and S. Rosenbaum and P. Shin, "Health Centers as Safety Net Providers: An Overview and Assessment of Medicaid's Role," Figure 6, May 2003, http://www.kff.org/ medicaid/4113-index.cfm (accessed 26 March 2007).
19. S. Geller, B.M. Taylor, and H.D. Scott, "Free Clinics Helping to Patch the Safety Net," Journal of Health Care for the Poor and Underserved 15, no. 1 (2004): 42-51.
20. See H.D. Scott et al., "Physicians Helping the Underserved: The Reach Out Program," Journal of the American Medical Association 283, no. 1 (2000): 99-104.
21. Additionally, the Volunteers in Medicine Institute serves as a resource for clinics that replicate the approach of Volunteers in Medicine in Hilton Head, South Carolina. The American Project Access Network plays a similar role for clinics that adopt the approach of Project Access, located in Asheville, North Carolina.
22. M.M. Nadkarni and J.T. Philbrick, "Free Clinics and the Uninsured: The Increasing Demands of Chronic Illness," Journal of Health Care for the Poor and Underserved 14, no. 2 (2003): 165-174.
23. HRSA, "Welcome to Pharmacy Services Support Center," http://pssc.aphanet.org (accessed 12 February 2007).
24. P.A. Hattis, "Overcoming Barriers to Physician Volunteerism: Summary of State Laws Providing Reduced Malpractice Liability Exposure for Clinician Volunteers," University of Illinois Law Review 2004, no. 1 (2004): 167-181.
25. HRSA's Report to Congress found that fifteen clinics had obtained coverage as of 2003. As of March 2007, seventy-five clinics had obtained coverage under the Federal Tort Claims Act. Martin W. Hiller, founding board member, National Association of Free Clinics, personal communication, 16 March 2007.
26. D. Solomon and D. Wessel, "Health-Insurance Gap Surges as Political Issue,"Wall Street Journal, 19 January 2007;
27. and S.G. Stolberg and R. Pear, "Bush Urges Tax to Help Cover the Uninsured," New York Times, 21 January 2007.