This Insights was contributed by Navid Amlani, Pharm. D., a pharmacist at New Hanover Regional Medical Center and volunteer with Cape Fear Clinic.

The World Bank estimates the United States spends approximately 17 percent of its gross domestic product on health care. Hospitalizations and emergency department visits contribute significantly to these health care costs.

According to the Agency for Healthcare Research and Quality (AHRQ), the average cost per hospital stay in 2012 was $8,500, an increase of about 2 percent from 2008 to 2012. The AHRQ also reports that, since 2000, the increase in emergency department visits outpaced the growth of the U.S. population. Half of these visits resulted in admission to the hospital.

Even without a hospital admission, a patient may face significant costs for visits to the emergency department. A recent study published in PLOS One showed the average cost for an emergency department visit was about $1,200, more than the average American pays each month for rent. Further, the study found that Medicaid patients were generally charged the most.

Clearly, emergency department visits and hospitalizations are major contributors to health care expenditures. Therefore, it is of great importance to find ways to prevent emergency department visits and admissions to the hospital in order to contain costs. Two ways to prevent hospitalizations are proper medication management and provision of vaccinations.

Since emergency department use reflects the health needs of the greater community, the AHRQ reports that access to high-quality, community-based care can prevent visits to the emergency department. Likewise, a recent report from the Network for Excellence in Health Innovation states that improving patient medication adherence is central to reducing hospital readmissions. According to the World Health Organization and the Centers for Disease Control and Prevention, vaccines help decrease the worldwide burden of infectious diseases, curb antibiotic overuse and subsequent development of resistance and reduce both direct and indirect costs.

Taken together, these statements show that patient access to a primary care provider, effective medication management and timely provision of vaccines can help prevent emergency department visits and subsequent hospital admissions. For patients recently discharged from the hospital, these services may lessen the likelihood they will be readmitted.

Cape Fear Clinic, a local community-based clinic, provides compassionate, affordable, patient-centered care for low-income individuals and families in the Cape Fear region. They provide comprehensive medical and pharmaceutical care services. Since the clinic cares for patients regardless of ability to pay, they are in a unique position to help reduce emergency department visits, hospitalizations and overall cost burdens for the most vulnerable patients.

Cape Fear Clinic offers access to high-quality primary care. Low-income individuals are ensured comprehensive, patient-centered care and follow-up, as well as access to much-needed medications and vaccines. Since these services are offered at little or no cost to the patient, patients are much more likely to participate in regular medical follow-up.

Because the Cape Fear Clinic offers in-house pharmaceutical services, they are able to provide comprehensive medication management. Through a variety of mechanisms, including manufacturer programs, institutional patient-access programs, and direct donations, the clinic is able to ensure consistent access to prescription medications.
Further, patients can be effectively counseled on how to use their medications properly. The clinic’s pharmacy also offers a comprehensive vaccination program at little to no cost to its patients.

Through all of these services, the Cape Fear Clinic doesn’t just serve the region’s low-income patients; it also provides a valuable service for the region at large. Through the provision of quality primary care services, pharmaceutical care and routine vaccinations, clinic staff and volunteers are able to help keep people out of the emergency department and the hospital, thereby contributing to both better health outcomes and a reduced cost of care to both patients and the community.

Photo by Mark Steelman, c/o Greater Wilmington Business Journal
 
Cape Fear Clinic, Inc., a 501(c)(3) non-profit corporation, was founded in 1991 as Tileston Health Clinic, Inc. and provides healthcare to those in our community who would otherwise be unable to access care. The clinic serves charitable patients who do not have health insurance and have incomes of no more than 200 percent of federal poverty guidelines, and those with Medicaid. For more information please visit capefearclinic.org or contact us at (910) 343-8736.