Title: Reducing non-urgent utilisation of the emergency department by the uninsured: analysis of the impact of a community-wide provider network

Authors: Karen Van Caulil, Timothy Rotarius, Aaron Liberman

Addresses: Health Council of East Central Florida, Inc., 2461 W. State Road 426, Suite 2041, Oviedo, FL 32765, USA. ' Department of Health Professions, College of Health and Public Affairs, University of Central Florida, HPA II, Suite 210, Orlando, FL 32816-2205, USA. ' Department of Health Professions, College of Health and Public Affairs, University of Central Florida, HPA II, Suite 210, Orlando, FL 32816-2205, USA

Abstract: Post-EMTALA, proactive communities throughout the USA have strengthened their safety net systems to meet the healthcare needs of the ever-increasing uninsured population. This paper describes the evaluation of a community-wide initiative in Orange County, Florida to reduce non-urgent Emergency Department (ED) utilisation by uninsured patients through increased use of Community Health Centers (CHCs). National, state and local efforts designed to redirect uninsured patients from hospitals to CHCs for non-urgent care have been challenged by the complexities associated with evaluating effectiveness and quantifying community impact. This research provides a model to local communities and policy analysts for evaluating these initiatives.

Keywords: CHCs; community health centers; emergency department utilisation; health policy; public policy; healthcare provision; USA; United States; uninsured patients; community impact.

DOI: 10.1504/IJPP.2008.020990

International Journal of Public Policy, 2008 Vol.3 No.5/6, pp.389 - 402

Published online: 30 Oct 2008 *

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