The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64172

Jim Walton, DO, Office of Community Health, HealthTexas Provider Network, Baylor Health Care System, 8080 N. Central Expressway, Suite 1700, Dallas, TX 75206, 214.860.8626, jameswa@baylorhealth.edu and Michael Darrouzet, Dallas Academy of Medicine, Dallas County Medical Society, P.O. Box 4680, Dallas, TX 75208.

Volunteer health care delivery systems frequently emerge spontaneously in cities and communities with high numbers of uninsured residents. Project Access (PA) in Dallas, Texas is a HRSA Community Access Program (CAP) funded project with a research infrastructure funded through the CDC community-based participatory research program. The project was initiated in 1997 to improve access to care for the city's 250,000 adults who are ineligible for existing public safety net programs. PA utilizes the local medical society (5,800 member physicians) to increase physician participation in community volunteerism, while coordinating medical care with other community-based services donated by local hospitals, pharmacies, laboratories and ancillary services, and faith-based organizations (FBOs).

Administering a large volunteer-based system of care presents numerous challenges. For example, limited numbers of subspecialty physician volunteers can contribute to protracted waiting periods for these services, which create back-logs in volunteer clinics and encourage patients to access care through hospital emergency rooms. Project Access addressed this challenge by developing an internet-based information system that is integrated with the medical society physician database. The database allows emergency departments, community clinics and private physicians to enroll and refer patients within the PA network. The effectiveness of PA in identifying and resolving program development challenges will be discussed through presenting outcomes data related to the project's community care coordination network, the pharmacy benefit program, the structure of the outcomes measurement system, the level of patient and provider participation, and provider and patient satisfaction with the system.

Learning Objectives:

• Describe and discuss the role of organized medicine (a county medical society) in increasing professional volunteerism.
• Understand the challenges encountered in setting up an effective system of volunteer-based care integrated with local non-profit health clinics.
• Review the early indicators of success of community-based professional involvement in improving health access and reducing health disparities.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.