The Effect of a Student-Run Free Clinic on Hospital Utilization

Area of Science:

• Health Services Research
• Medical Education
• Public Health

Background:

• Student-run free clinics (SRFCs) provide care to uninsured populations and offer valuable training for medical students.
• The impact of SRFCs on overall healthcare utilization, particularly hospital admissions, remains under-investigated.
• Understanding SRFCs' effect on the healthcare system is crucial for resource allocation and policy development.

Purpose of the Study:

• To determine if patient enrollment in the Shade Tree Clinic (STC), a student-run free clinic affiliated with Vanderbilt University Medical Center (VUMC), is associated with decreased hospital utilization.
• To analyze the specific impact of VUMC referrals to STC on patient hospitalization rates.

Main Methods:

• A pre-post observational study design was employed.
• Multivariable modeling was used to assess changes in hospital utilization among STC patients after enrollment.
• Univariate Wilcoxon signed-rank tests were conducted for a sub-analysis of patients referred from VUMC.

Main Results:

• Multivariable analysis indicated a statistically significant decrease in hospitalizations for patients after joining the Shade Tree Clinic (p=.04).
• Sub-analysis of VUMC-referred patients also showed a significant difference in hospitalizations (p=.02).
• The findings suggest that STC does not increase the burden on the healthcare system.

Conclusions:

• Student-run free clinics, like Shade Tree Clinic, may reduce hospital utilization among the uninsured.
• These findings indicate that SRFCs can be an efficient component of the healthcare system, potentially mitigating healthcare costs.
• Further research, including studies with control groups, is recommended to fully elucidate the impact of SRFCs on healthcare utilization patterns.