Student Faculty Collaborative Clinics Influence on Emergency Department Use

Student-faculty collaborative clinics, like the Crimson Care Collaborative (CCC), provide primary care access to underserved communities. Affiliated with a community health center, CCC-Chelsea serves a largely immigrant and refugee population. This study aimed to analyze patients' reported ED use before and after they presented to CCC-Chelsea and whether types of insurance affect ED use. We prospectively surveyed 229 patients presenting to CCC-Chelsea between 2013 and 2019. Patients who presented for two or more visits at least one year apart were included in the study. A two-sided Wilcoxon signed rank test was used to compare reported ED use before and after presenting to CCC-Chelsea, and a Kruskal-Wallis test analyzed the association between ED use and insurance status. Most patients (77.7%) presenting to CCC-Chelsea identified as Hispanic, 70.9% were male, 50.6% of patients reported an income of less than $15,000 yearly, and 30.4% had an income between $15,000-$30,000. Most patients (51.9%) did not specify the type of insurance used, followed by public insurance (36.7%), with the remaining having private or no insurance. Results from our survey showed that patients who returned to CCC-Chelsea reported a decrease in the average number of yearly ED visits after attending CCC-Chelsea (pre-CCC 1.544, post-CCC 0.696, p < 0.001 at the 95% CI). There was no difference in reported average number of ED visits yearly and insurance type (p = 0.579). Patients' reported ED utilization after accessing care at CCC-Chelsea decreased. Increased access to student-faculty collaborative clinics could reduce ED use in underserved populations.