Pilot study of ER utilization at Tulsa hospitals.

CONTEXT: The Tulsa Community Access Program (TCAP) project has been developed to address the health care needs of the uninsured and underinsured population in the Tulsa MSA. One of the objectives is the development of a 24/7 Care Center. OBJECTIVE: To complete a pilot study on patient demographics and utilization patterns in the Emergency Room (ER) to determine if a 24/7 clinic is needed or would be used as an alternative site for treatment. DESIGN: A survey was randomly administered to ER clients from March 2003 to April 2003 and included 45 open-ended, closed-ended, and Likert scale questions. Acuity level of care was verified by a hospital professional. SETTING: Hillcrest Medical Center, Tulsa, provides a significant amount of indigent care; four time periods were picked for peak and varied ER usage. PARTICIPANTS: 200 ER clients, 50 per time period; survey administration and data analysis were done by University of Oklahoma-Tulsa graduate students. MAIN OUTCOME MEASURE(S): Prior assumptions: uninsured/underinsured use the ER for primary care; demographics of the ER client are low income/unemployed, low education; majority of ER clients are non-urgent/non-emergency and would use a 24/7 clinic. RESULTS: 56% have used ER 1-2 times in past year; 89% of cases were non-urgent/non-emergency; 46% graduated high school; 48% work full-time; 42% have family income 15,000 dollars or less; 76.5% favor an after hours primary care clinic. CONCLUSIONS: This survey is an important tool to determine the needs and patterns of ER utilization; there is a need for a 24/7 clinic and it would be used by the target population.

Tulsa health care challenge: a compilation of issues and possible solutions.

The delivery of adequate health care to "all of the people" has become an increasing challenge in the United States. The problem of timely access to affordable health care is even more serious in Oklahoma. The University of Oklahoma-Tulsa Health Science Center, the OU College of Medicine-Tulsa, and Community HealthNET, Inc. have taken leadership roles in convening two Oklahoma Health Care Challenge summit meetings this past year. Tulsa community leaders are now addressing the seriousness of the local problem and, more importantly, are coming up with ways to alleviate it. The focus of the summits has centered on providing indigent care, which will provide relief to the Tulsa hospitals and physicians from the growing burden of charity care costs. The most beneficial results of these meetings have been a clearer definition of the problem specific to Tulsa, the recognition that the solution will require coalitions of multidisciplinary groups, and the realization that cooperation, as well as collaboration, is the key to success.