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Safety Net Clinics Improved Care, Limited Medical Debt Post-Katrina, Says Study

Janice Simmons, for HealthLeaders Media, January 20, 2010

Despite being disproportionately low income and uninsured, many safety net clinic patients in New Orleans had fewer problems paying for care post-Hurricane Katrina. There were also fewer cases of medical debt and inefficient care compared to most American adults, according to a new survey from the Commonwealth Fund.

Overall, the report, Coming Out of Crisis: Patient Experiences In Primary Care In New Orleans, Four Years Post Katrina, found that among all the clinic patients surveyed, only 27% went without needed healthcare because of cost—compared to 41% of adults nationwide.

In 2007, New Orleans' major public hospital and adjacent ambulatory sites were closed, but the Department of Health and Human Service provided a grant to Louisiana to support a network of independent neighborhood primary care centers 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. It also looked at 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 representative survey of the nation's general population, they found that the clinic patients tended to be less worried about affordability.

Almost half of clinic patients (49%) said they were confident they could afford needed care if they became seriously ill—compared with only 30% of adults in the general population.

In addition, medical debt also seemed to be less of a concern for clinic patients, with 34% reporting medical bills or debt problems compared to 40% nationwide. Unpaid medical bills appeared to be a far greater problem among all U.S. adults than among clinic patients (28% vs. 18%).

Clinic patients also reported receiving care that was more efficient than the US norm. For instance, only 4% of the clinic patients reported duplicate medical tests, or said that medical records or test results were unavailable at their appointment, while 34% of patients nationwide said they experienced those problems.

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