Evaluation of access,a primary care program for indigent patients: inpatient and emergency room utilization

We analyzed the impact of a program that provides indigent patients with free primary care on inpatient admissions, emergency room (ER) visits, and resulting charges in 91 patients before and after admittance into the program.There was a decrease in ER visits after enrolling in the program (1.89 versus 0.83 visits per year; p < 0.0001). This difference translated into mean ER charges of $1174 vs. $717 (p = 0.0007), and a decrease in charges of $41,587 per year. The charges for the program (outpatient visits and laboratory) were $23,141. Entry into the program had no effect on inpatient admissions, which averaged 0.07 admissions per year both before and after admission to the program.Indigent patients enrolled in a complimentary primary care program had significantly decreased per-year ER utilization rates and charges. The program had no effect on inpatient admissions. By conservative estimate, the program decreased ER charges by approximately $18,000 per year secondary to decreased ER utilization.