Evaluation of Hospital-Based Acute Care Utilization by Uninsured Patients Enrolled in Free or Low-Cost Pharmacy Programs

Abstract

Background: Research is warranted to define the role of affordable pharmacy programs in optimizing healthcare utilization for uninsured patients. Methods: This was a pre-post study including uninsured patients from an internal medicine residency clinic who enrolled in free or low-cost pharmacy programs with clinical pharmacist support. Results: In the period following program enrollment (N=116), there was a mean decrease of 0.23 acute care encounters (hospitalizations and emergency department [ED] visits) per patient (p=0.0210, 95% CI 0.04-0.43). The mean decrease for hospitalizations was also statistically significant (0.17, p=0.0052, 95% CI 0.05-0.28), but the mean decrease for ED visits was not (0.06, p=0.3771, 95% CI -0.08-0.21). Using the national average hospitalization cost of $10,700, the decrease in hospitalizations represents an estimated savings of $246,100. Conclusions: Enrollment in affordable pharmacy programs was found to be associated with decreased acute care encounters.

Consequences of cost barriers to prescriptions: cohort study in Aotearoa New Zealand

“…This calculation is based on the assumption of causality, which may not be the case. However, the concurrence of our results with those from experimental 14,15 and other observational studies of different designs 22,23 reinforces the likelihood of there being a causal link between lack of access to medication and increased hospitalisations.…”