Uninsured community health center patients often have difficulty accessing specialt...( BOSTON Mass. (September 11 2007)Unin...),Health

BOSTON, Mass. (September 11, 2007)Uninsured patients in publicly funded community health centers face significant obstacles accessing specialty services outside of these centers, a new study finds. Whats more, this is even the case after a doctor has determined that the patient does in fact need these services. Conversely, community health center patients with private insurance have a relatively easier time accessing services.

Often times, people think that community health centers act as a kind of safety net for the uninsured, but these findings present a far more problematic picture, says Nakela Cook, a research fellow in the Health Care Policy Department, and the lead author on the paper that will be appearing in the September/October edition of the journal Health Affairs.

According to Bruce Landon, associate professor in Harvard Medical Schools Health Care Policy Department and senior author, Community health centers work well for primary care services provided on site. The breakdown occurs when an uninsured patient needs to see a specialist, or needs some sort of high-tech service, or to be admitted to a hospital. Uninsured patients, and to a lesser extent Medicaid patients, have a much harder time than insured patients.

Community health centers serve approximately 15 million people nationwide, most of whom are low income and either lack insurance altogether or rely on programs like Medicaid. While these centers often provide adequate primary on-site services, many question how successfully they can refer patients to other more specialized services, even when a patient has a potentially life-threatening condition.

In order to investigate this, a research team led by Cook sent surveys to the directors of all federally qualified community health centers in the United States. Fifty-four percent of the medical directors responded.

The surveys focused on seven primary areas, and in each of them, uninsured patie
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