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.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9710298; ProQuest document ID: 304365098. The author still retains copyright.

Author Details

Dr. Betty Smith-Campbell, RN, PhD, APRN, CNS

Sigma Membership

Epsilon Gamma at-Large

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Mixed/Multi Method Research

Keywords:

Health Care Access, Uninsured Patients, Community Clinics

Advisors

Brown, Nancy

Degree

PhD

Degree Grantor

University of Colorado Health Services Center

Degree Year

1996

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2019-04-04

Full Text of Presentation

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