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Despite operation outside of safety net system, free clinics integral component of U.S. health care structure
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In a nationwide survey, free clinics were shown to provide valuable assistance to nearly 2 million uninsured individuals in the United States.
Data sources for this survey, published in the Archives of Internal Medicine, included all known free clinics in the United States (n=2,545). Clinics were excluded if they were supported directly by federal programs, exceeded a $20 threshold amount considered “nominal” and conditioned services on payment. Researcher Julie S. Darnell, PhD, with the University of Illinois at Chicago, sent out mail surveys to the final study population (n=1,188), of which 945 (79.5%) were returned. Overall, Darnell determined 1,007 free clinics to exist throughout 49 states and the District of Columbia, with Alaska as the only exception.
These clinics provided care for 1.8 million individuals, accounting for 3.5 million medical and dental visits. The mean operating budget was $287,810. Overall, 58.7% received no government revenue. Clinics were open a mean of 18 hours per week and generally provided medications (86.5%), physical examinations (81.4%), chronic disease management (73.2%) and urgent/acute care (62.3%).
According to Darnell, this was the first census of free clinics in 40 years. This study, she wrote, “suggests that free clinics are a much more important component of the ambulatory care safety net than generally recognized. … Formal integration of free clinics into the safety net has the potential to strengthen the overall health system, which is important regardless of the outcome of the national health reform debate.”
Darnell J. Arch Intern Med. 2010;170:946-953.