Access: Effects of a State-funded Policy in One Community

Abstract

America is in the midst of a health care crisis, and access to health care is a significant problem. As this crisis has escalated with little response from the federal government, state governments have begun to respond. For example, Kansas enacted a law in 1991 (HB 2019) to provide funding for primary care services for the medically indigent. Health Care Access (HCA), a community based volunteer clinic in Douglas County, KS, received this state funding and the services they provided increased dramatically. Little research has been done to assess the impact of organizations, such as HCA, on access to care. The purpose of this research study was to determine whether this state funding policy influenced access to health care for the medically indigent in Douglas County, KS.

This quantitative descriptive study was guided by the Aday, Anderson and Fleming (1980) Access Framework. A descriptive design was used to gather information on the characteristics of the health care system and the medically indigent in Douglas County, KS. To determine whether state funding for primary health care services for the medically indigent in Douglas County, KS decreased Emergency Department (ED) visits by the uninsured, a retrospective design was employed. Client satisfaction with care at HCA was examined using a cross sectional survey.

It was revealed in the findings that the uninsured visited the ED proportionately more frequently than the insured. The data showed that within three years after state funding of HCA was initiated, uninsured visits to the ED decreased by 63 percent, while insured visits continued to increase. The survey results revealed that HCA clients had a high level of satisfaction with the care they received at HCA.

In the era of accountability and downsizing of government services, state funded initiatives need to be evaluated to assess their effectiveness. This study will allow Kansas state legislators to evaluate the influence of one state policy on access to health care. Most importantly, legislators and citizens need to be informed that their financial and volunteer support can influence the availability and utilization of services and the satisfaction of services of the medically indigent.