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Brief communication 157 REACHING OUT TO THE UNDERSERVED: A COLLABORATIVE PARTNERSHIP TO PROVIDE HEALTH CARE For the past several decades, health care providers, educators, and policy makers have worked to solve the health care problems of the underserved and uninsured in our nation. However, in some instances, communities are experiencing greater health difficulties (e.g., infant mortality, teenage pregnancy ), and the number of uninsured individuals and families continues to rise. This article describes a community-academic partnership's response to the issue of care for the uninsured. The partnership has developed a program in which private physicians and other professionals are challenged to expand their role in caring for medically underserved people by volunteering their services. The partnership was formed in 1993 in Montgomery County, Ohio to develop an innovative solution to the lack of access to health care among the uninsured. In the Dayton community, the partners consisted of the Montgomery County Medical Society, the Combined Health District of Montgomery County, and the Wright State University School of Medicine. In a collaborative effort, these and other partners developed and implemented a method of health care delivery that brings voluntary practicing physicians and other voluntary health care providers into settings where they provide direct healthcare to the underserved in the community. The program identifies and uses the "untapped benevolence" among physicians in the community, and provides a structure with minimal constraints. The following steps were involved in developing and implementing Montgomery County's Reach Out initiative: (1) definition of the problem, (2) identification of existing barriers, (3) establishment and growth of the partnership, (4) development of a model for change including goals/objectives and principal achievements, and (5) development of a plan for long-term financial stability of the program. Definition of the problem Montgomery County, Ohio has experienced problems in the provision of care to its underserved community. These problems are similar to those of other counties within Ohio, and elsewhere in the United States, in which a relatively large urban city is located (in this case Dayton). For example, a 1993 report from the Ohio Department of Health Office of Health Policy and Journal of Health Care for the Poor and Underserved · Vol. 10,No. 2 · 1999 158 Reaching Out to the Underserved Analysis designated an urban section of Dayton as a "health professions shortage area" in which an estimated 58 percent of the 42,000 residents were unserved.1 The Combined Health District of Montgomery County operated four primary care health centers and four child health centers in ¿lis area, serving about 14,000 individuals. Of that number, roughly 40 percent were uninsured and low-income workers, and the remainder were on Medicaid or Medicare. These neighborhood health centers were at or near capacity in terms of their ability to serve clients. In addition, in 1993, approximately 9,900 emergency room visits were made by patients having no resources with which to pay. Data from 1994 ranked Montgomery County fourth in size among 88 counties in Ohio with approximately 574,000 residents. About 63,000 or 11 percent of the population are uninsured, and more of the poor (29 percent) than nonpoor (10 percent) are uninsured. The working poor are more likely to be without health insurance (44 percent) than the nonworking poor (18 percent). These statistics alone were indicative of availability and access problems; however, the number of uninsured (comprising 11 percent of the total population , much higher within the targeted inner-city population) was the most compelling reason to develop the proposed system of volunteer physicians and other supportive health care providers. Other indicators included increases within the last 20 years in the number of Dayton families living under the poverty level (10.6 to 22 percent), a doubling of single-parent households, and the percentage of children born to teenagers rising to 21.5 percent. Establishment and growth of the partnership A partnership formed among three primary organizations: the Montgomery County Medical Society, the Combined Health District of Montgomery County, and the Wright State University School of Medicine. The Montgomery County Medical Society was chosen as a partner because it represented the largest majority of physicians in Montgomery County (83 percent and 1,000...

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Additional Information

ISSN
1548-6869
Print ISSN
1049-2089
Pages
pp. 157-168
Launched on MUSE
2010-03-25
Open Access
No
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