University of Texas Southwestern Medical Center, Dallas, TX, USA.
University of Texas at Arlington, Arlington, TX, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241304143. doi: 10.1177/21501319241304143.
INTRODUCTION/OBJECTIVES: The cost of medical services is a major barrier to healthcare accessibility for underserved populations in the United States. Community charity medical clinics help address this disparity by providing free or reduced-cost care for the medically underinsured; however, their economic and public health contributions are unknown. The objective of this study was to evaluate the scope of services and monetary impact of 4 community charity medical clinics in North Texas, with one of the largest medically underinsured populations in the United States.
A cross-sectional study was conducted using electronic health records from 4 clinics serving adults and children in North Texas. Encounters from June 1 to December 31, 2018 completed by with sufficient documentation to assign a level of service were reviewed. There were 3942 encounters identified and 2148 (54.5%) audited. Centers for Medicare and Medicaid Services Evaluation and Management Standards were used to identify level of service provided for each encounter, and their subsequent value was determined based on CMS fee-for-service schedules at the time service was provided. Common conditions managed during these encounters were identified using ICD-10 codes documented with each encounter.
The most prevalent diagnoses encountered were hypertension, diabetes, hyperlipidemia, and major depressive disorder. We estimate the total value of services and medications provided for 1 year is between $840 278.30 to $845 737.41.
The charity clinics in North Texas provide a significant economic impact through a high level of charity care and a broad scope of services for a vulnerable patient population. The results may be used in the development and implementation of future services to meet the needs of the medically underinsured.
介绍/目的：在美国，医疗服务的成本是服务不足人群获得医疗保健的主要障碍。社区慈善医疗诊所通过为未充分投保的人提供免费或降低成本的医疗服务来帮助解决这种差距；然而，它们的经济和公共卫生贡献尚不清楚。本研究的目的是评估美国德克萨斯州北部 4 家社区慈善医疗诊所的服务范围和货币影响，其中一家拥有美国最大的未充分投保人群。
对德克萨斯州北部为成人和儿童服务的 4 家诊所的电子健康记录进行了一项横断面研究。对 2018 年 6 月 1 日至 12 月 31 日期间完成的记录进行了审查，这些记录有足够的文件记录来确定服务级别。共确定了 3942 次就诊，其中 2148 次（54.5%）进行了审核。使用医疗保险和医疗补助服务评估和管理标准来确定每次就诊提供的服务级别，并根据服务提供时的医疗保险按服务收费计划确定其后续价值。使用每次就诊记录的 ICD-10 代码确定就诊时管理的常见疾病。
最常见的诊断是高血压、糖尿病、高血脂和重度抑郁症。我们估计，1 年内提供的服务和药物总价值在 840278.30 美元至 845737.41 美元之间。
德克萨斯州北部的慈善诊所通过高水平的慈善护理和为弱势患者群体提供广泛的服务，产生了重大的经济影响。这些结果可用于制定和实施未来的服务，以满足未充分投保人群的需求。
