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Monday, 18th January 2010

New Report: Post-Katrina Safety-Net Clinic Patients in New Orleans Report More Efficient and Affordable Health Care and Less Medical Debt Than Most U.S. Adults; Pilot Could Serve as National Model

New Report: Post-Katrina Safety-Net Clinic Patients in New Orleans Report More Efficient and Affordable Health Care and Less Medical Debt Than Most U.S. Adults; Pilot Could Serve as National Model
Source: The Commonwealth Fund

A new Commonwealth Fund survey of safety-net clinic patients in New Orleans finds that, despite being disproportionately low-income and uninsured, these patients had fewer problems affording care and fewer instances of medical debt and inefficient care than most U.S. adults. In fact, the report, Coming Out of Crisis: Patient Experiences In Primary Care In New Orleans, Four Years Post Katrina, finds that, among the clinic patients surveyed, only 27 percent went without needed health care because of cost, compared with 41 percent of adults across the country.

According to the authors, this shows that the post-Katrina primary care pilot program—a system that relies primarily on a large network of local clinics funded by federal and local government, and given financial incentives to improve care—could serve as a national model for providing primary care to vulnerable groups.
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With New Orleans' major public hospital and adjacent ambulatory sites closed, in 2007 the U.S. Dept. of Health and Human Service gave a grant to the state of Louisiana that supported a network of independent neighborhood primary care centers in efforts to increase access to care and develop an organized system of care. The Commonwealth Fund survey was conducted 18 months after the grant was awarded to assess the impact of the project on patients’ access to care and experiences, and provide lessons for national and state leaders on the value of strengthening primary care for vulnerable patients.

When the authors compared the 2009 survey of patients in 27 New Orleans health clinics to findings from The Commonwealth Fund's 2007 Biennial Survey, a nationally representative survey of the general population, they found that clinic patients were less worried about affordability overall. In fact, half of clinic patients (49%) reported they were confident they could afford needed care if they became seriously ill, compared with only 30 percent of adults in the general population. Medical debt was also less of a concern for clinic patients, with 34 percent reporting medical bills or debt problems compared to 40 percent in the U.S. overall. Unpaid medical bills were also a far greater problem among all U.S. adults than among clinic patients (28 percent vs. 18 percent).

Clinic patients also received care that was more efficient than the U.S. norm. According to the report, only 4 percent of clinic patients reported duplicate medical tests, or that medical records or test results were unavailable at their appointment, while overall, 34 percent of U.S. patients experienced such problems. Clinic patients also had more confidence in the health care system—three-quarters said they would be very confident in their ability to get high-quality and safe medical care; in contrast, only 39 percent of all U.S. adults were very confident that they could get high quality and safe care.

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