The Impact of an Insurance Administration–Free Primary Care Office on Hospital Admissions

This study compares hospital admissions over a 3-year period (2009-2011) between a community's 2 major private, fee-for-service physician groups and an insurance administration-free, hospital-affiliated clinic designed to provide a full array of primary care services to low-income individuals at little or no cost. We use data on patients' chronic conditions and inpatient hospital admissions to compare patients' average number of physician office visits and overall hospital admission rates per 1000 patients. The data indicate that while clinic patients have a higher (or equal) average number of chronic conditions compared with patients in the private physician groups, they exhibit lower hospital admission rates. Clinic patients also exhibit a higher average annual frequency of physician visits. Results of this study suggest that enhanced access to primary care could help mitigate inefficient use of non-urgent care hospital resources for the uninsured and reduce costly hospitalizations even in the short run.