Impact of Student-Run Free Clinics in Urgent Care.

As Emergency Departments (EDs) become increasingly crowded, the non-urgent use of EDs exacerbates this problem. Uninsured patients have the highest percentage of non-urgent ED visits and free healthcare clinics provide access to care for the uninsured. This study analyzed the patient population of the 12th Street Health and Wellness Center (HWC), a student-run free clinic (SRFC), to understand the impact of SRFCs in urgent care. 2024 return and new patient intake forms from the HWC were analyzed. Multivariable logistic regression was performed to see which factors from the patient intake forms increase the probability that a patient came will into the clinic for urgent care. About 10% of the HWC patient population uses the clinic for emergencies, of which, 94% of them were not referred to the ED. If the HWC was not available, most of these uninsured individuals would have gone to an ED and incurred an estimated total cost of $39,515.80 in 2019. Multivariable logistic regression indicated that patients that came via walk-in are significantly more likely to seek urgent care at the clinic. Further, patients without insurance and patients who need a Spanish interpreter have a higher tendency to seek urgent care at this clinic. SRFCs save their surrounding EDs thousands of dollars in non-urgent ED visits. SRFCs should be attentive to patients who come in without an appointment, without insurance, and who need a Spanish interpreter because they are more likely to come in for an emergency.

Infant mortality in the Lower Mississippi Delta: geography, poverty and race.

OBJECTIVE: The objectives of this study were to explore regional, economic and racial disparities in infant mortality rates between geographic sub-regions within the eight states containing the Delta and to test hypotheses that regional disparities would decrease over time while county poverty level and racial composition would remain significant predictors of infant mortality rates. STUDY DESIGN: The study used secondary data analysis of county level rates, including descriptive statistics, hierarchical multiple regression with interaction effects and linear multiple regression. Models testing the impact of sub-regional geographic differences, percent of poverty, percent of black population and interaction effects were conducted at three time periods, the late 1970s, late 1980s and late 1990s. RESULTS: In the first time period, regional differences, percent of poverty, percent of black population and the interaction of region and poverty were all predictive of infant mortality (R(2) = 0.31, P < 0.0001). In the subsequent time periods, only percent of poverty and percent of black population were significant predictors (R(2) = 0.20, P < 0.0001 and R(2) = 0.26, P < 0.0001). CONCLUSIONS: During the late 1970s and early 1980s, region, poverty and racial composition of counties all played an important part in predicting life chances for infants born in these eight states. Furthermore, Central Delta infants in counties with poverty levels of 30% or greater were significantly more likely to die than infants in other areas with the same rates of poverty, even after controlling for racial composition. The impact of regional differences was no longer significant at the ends of the subsequent two decades. Both medical and policy changes during these decades may have contributed to the decreased impact of region. However, both poverty and racial composition continue as important factors, accounting for more variance in the late 1990s than a decade before.