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Free Clinics Hold Meaningful Role in Nation's Safety Net

Also, practices serving minorities, disadvantaged often offer medical home capabilities

WEDNESDAY, June 16 (HealthDay News) -- Free clinics appear to be an important component of America's health care safety net, and primary care practices that serve sociodemographically vulnerable neighborhoods may be more likely than other practices to offer capabilities often associated with the medical home concept, according to research published in the June 14 issue of the Archives of Internal Medicine.

Julie S. Darnell, Ph.D., of the University of Chicago analyzed data from a survey of all known free clinics in the nation. According to the researcher, 1,007 free clinics are known to exist throughout the United States, save for Alaska. These clinics serve 1.8 million people and provide 3.5 million medical and dental visits annually. The average annual operating budget was found to be $287,810. Clinics were open an average of 18 hours a week, and they typically offered medications (86.5 percent), physical examinations (81.4 percent), chronic disease management (73.2 percent), and urgent/acute care (62.3 percent). However, 58.7 percent of the clinics did not receive government revenue.

Mark W. Friedberg, M.D., of Brigham and Women's Hospital in Boston, and colleagues analyzed data from 308 Massachusetts primary care practices, assessing their use of capabilities often included in medical home proposals, including patient reminders and electronic health records. Practices serving disproportionate numbers of patients living in neighborhoods with a high prevalence of minorities or residents at economic disadvantage were more likely to have features such as on-site interpreters, multilingual clinicians, and multifunctional electronic health records.

"Contrary to expectations, primary care practices serving sociodemographically vulnerable neighborhoods were more likely than other practices to have structural capabilities commonly included in medical home proposals. Payments tied to these capabilities may aid practices serving vulnerable populations," Friedberg and colleagues conclude.

Abstract - Darnell
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Abstract - Friedberg
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