The following is a summary of “Predictors of intent to utilize the emergency department among a free clinic’s patients,” published in the September 2023 issue of Emergency Medicine by Nguyen, et al.

For a study, researchers sought to investigate the association between the use of free clinics and the intent to seek care at the emergency department (ED) among patients without insurance. The primary objective was to assess whether patients who frequently used free clinics were less likely to express an intent to visit the ED in the absence of free clinic services.

Data were obtained from electronic health records within a network of free clinics covering adult patients from January 2015 to February 2020. The main outcome was whether patients reported themselves as “very likely” to go to the ED if free clinics were unavailable. The independent variable was the frequency of free clinic utilization. Multivariable logistic regression models were employed to control for various factors, including patient demographics, social determinants of health, health status, and the effect of different years.

The sample consisted of 5,008 visits. After adjusting for other factors, the study found that certain patient characteristics, social determinants of health, and medical conditions were associated with an increased likelihood of expressing an intent to visit the ED. The factors included non-Hispanic Black ethnicity, older age, single marital status, living with others, lower educational attainment, homelessness, personal transportation availability, rural residence, and a higher comorbidity burden. In sensitivity analyses, specific medical conditions like dental, gastrointestinal, genitourinary, musculoskeletal, or respiratory issues were also linked to a greater likelihood of ED intent.

The research revealed that various demographic, social, and medical factors were independently associated with a higher likelihood of patients reporting their intent to visit the ED. To reduce the ED utilization of uninsured patients, additional interventions that enhance access to and utilization of free clinics, particularly for specific medical conditions such as dental issues, may be beneficial.

Source: sciencedirect.com/science/article/abs/pii/S0735675723003017