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Original article
peer-reviewed

Medical Care in a Free Clinic: A Comprehensive Evaluation of Patient Experience, Incentives, and Barriers to Optimal Medical Care with Consideration of a Facility Fee



Abstract

Free and charitable clinics are important contributors to the health of the United States population. Recently, funding for these clinics has been declining, and it is, therefore, useful to identify what qualities patients value the most in clinics in an effort to allocate funding wisely. In order to identify targets and incentives for improvement of patients’ health, we performed a comprehensive analysis of patients’ experience at a free clinic by analyzing a patient survey (N=94). The survey also assessed patient opinions of a small facility fee, which could be used to offset the decrease in funds. Interestingly, our patients believed it is appropriate to be charged a facility fee (78%) because it increases involvement in their care (= 0.69, < 0.001) and self-respect (= 0.66, < 0.001). Incentives to medical care include continuity of care, faith-based care, having a patient medical provider partnership, and charging a facility fee. Barriers include affordable housing, transportation, medication, and accessible information. In order to improve medical care in the uninsured population, our study suggested that we need to: 1) offer continuity of medical care; 2) offer affordable preventive health screenings; 3) support affordable transportation, housing, and medications; and 4) consider including a facility fee.



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Original article
peer-reviewed

Medical Care in a Free Clinic: A Comprehensive Evaluation of Patient Experience, Incentives, and Barriers to Optimal Medical Care with Consideration of a Facility Fee


Author Information

Antoinette Birs Corresponding Author

University of Central Florida College of Medicine

Xinwei Liu

University of Central Florida College of Medicine

Bee Nash

FIRE Module, University of Central Florida College of Medicine

Sara Sullivan

Consulting Department, Sullivan Evaluation Services

Stephanie Garris

Grace Medical Home

Marvin Hardy

Medical Director, Grace Medical Home

Michael Lee

Pharmacology, University of Central Florida College of Medicine

Judith Simms-Cendan

University of Central Florida College of Medicine

Magdalena Pasarica

Medical Education, University of Central Florida College of Medicine


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. University of Central Florida Institutional Review Board issued approval SBE-14-10831. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

Acknowledgements

We would like to thank the staff at Grace Medical Home for their guidance, time, and efforts with this project and all the Grace Medical Home patients who participated in this study.


Original article
peer-reviewed

Medical Care in a Free Clinic: A Comprehensive Evaluation of Patient Experience, Incentives, and Barriers to Optimal Medical Care with Consideration of a Facility Fee


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Original article
peer-reviewed

Medical Care in a Free Clinic: A Comprehensive Evaluation of Patient Experience, Incentives, and Barriers to Optimal Medical Care with Consideration of a Facility Fee

  • Author Information
    Antoinette Birs Corresponding Author

    University of Central Florida College of Medicine

    Xinwei Liu

    University of Central Florida College of Medicine

    Bee Nash

    FIRE Module, University of Central Florida College of Medicine

    Sara Sullivan

    Consulting Department, Sullivan Evaluation Services

    Stephanie Garris

    Grace Medical Home

    Marvin Hardy

    Medical Director, Grace Medical Home

    Michael Lee

    Pharmacology, University of Central Florida College of Medicine

    Judith Simms-Cendan

    University of Central Florida College of Medicine

    Magdalena Pasarica

    Medical Education, University of Central Florida College of Medicine


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. University of Central Florida Institutional Review Board issued approval SBE-14-10831. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements

    We would like to thank the staff at Grace Medical Home for their guidance, time, and efforts with this project and all the Grace Medical Home patients who participated in this study.


    Article Information

    Published: February 19, 2016

    DOI

    10.7759/cureus.500

    Cite this article as:

    Birs A, Liu X, Nash B, et al. (February 19, 2016) Medical Care in a Free Clinic: A Comprehensive Evaluation of Patient Experience, Incentives, and Barriers to Optimal Medical Care with Consideration of a Facility Fee. Cureus 8(2): e500. doi:10.7759/cureus.500

    Publication history

    Received by Cureus: November 30, 2015
    Peer review began: January 12, 2016
    Peer review concluded: February 16, 2016
    Published: February 19, 2016

    Copyright

    © Copyright 2016
    Birs et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Free and charitable clinics are important contributors to the health of the United States population. Recently, funding for these clinics has been declining, and it is, therefore, useful to identify what qualities patients value the most in clinics in an effort to allocate funding wisely. In order to identify targets and incentives for improvement of patients’ health, we performed a comprehensive analysis of patients’ experience at a free clinic by analyzing a patient survey (N=94). The survey also assessed patient opinions of a small facility fee, which could be used to offset the decrease in funds. Interestingly, our patients believed it is appropriate to be charged a facility fee (78%) because it increases involvement in their care (= 0.69, < 0.001) and self-respect (= 0.66, < 0.001). Incentives to medical care include continuity of care, faith-based care, having a patient medical provider partnership, and charging a facility fee. Barriers include affordable housing, transportation, medication, and accessible information. In order to improve medical care in the uninsured population, our study suggested that we need to: 1) offer continuity of medical care; 2) offer affordable preventive health screenings; 3) support affordable transportation, housing, and medications; and 4) consider including a facility fee.



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Antoinette Birs, Medical Student

University of Central Florida College of Medicine

For correspondence:
abirs@knights.ucf.edu

Xinwei Liu

University of Central Florida College of Medicine

Bee Nash

FIRE Module, University of Central Florida College of Medicine

Sara Sullivan

Consulting Department, Sullivan Evaluation Services

Stephanie Garris

Grace Medical Home

Marvin Hardy

Medical Director, Grace Medical Home

Michael Lee

Pharmacology, University of Central Florida College of Medicine

Judith Simms-Cendan, None

University of Central Florida College of Medicine

Magdalena Pasarica, M.D., Ph.D., Associate Professor

Medical Education, University of Central Florida College of Medicine

Antoinette Birs, Medical Student

University of Central Florida College of Medicine

For correspondence:
abirs@knights.ucf.edu

Xinwei Liu

University of Central Florida College of Medicine

Bee Nash

FIRE Module, University of Central Florida College of Medicine

Sara Sullivan

Consulting Department, Sullivan Evaluation Services

Stephanie Garris

Grace Medical Home

Marvin Hardy

Medical Director, Grace Medical Home

Michael Lee

Pharmacology, University of Central Florida College of Medicine

Judith Simms-Cendan, None

University of Central Florida College of Medicine

Magdalena Pasarica, M.D., Ph.D., Associate Professor

Medical Education, University of Central Florida College of Medicine