Study: Free clinics fill gaps in health 'safety net'

Free clinics across the U.S. provide care to about 1.8 million mostly uninsured patients annually, and the majority of clinics receive no government support, according to the first comprehensive survey of all known free clinics since the 1960s (Archives of Internal Medicine, June 2010, Vol. 170:11, pp. 946-953).

The study, conducted by University of Illinois at Chicago (UIC) researcher Julie Darnell, Ph.D., M.S.W., found 1,007 free clinics operating in the U.S., in every state but Alaska. Collectively, they provide an estimated 3.1 million medical visits and nearly 300,000 dental visits annually.

"The magnitude of care is much greater than what is generally recognized," said Darnell, an assistant professor of health policy and administration at the UIC School of Public Health, in a press release.

The study is based on survey results that include information on operations, patients, services, staff, and volunteers from more than 75% of free clinics existing during the survey period from October 2005 through December 2006.

There is no "typical" free clinic, according to the study. Free clinics are open, on average, about 18 hours per week; most have hours during the day and evening; they allow very flexible scheduling of patients, including walk-in visits; and they exist on very small operating budgets.

"Half of all clinics have budgets of less than $125,000," Darnell said, which shows how much care they provide with very little funding.

Free clinics serve a disproportionate number of racial and ethnic minority groups, but half of all patients are white. Most patients are women between 18 and 64, and are low-income (at or below 200% of poverty) but don't generally qualify for Medicaid or Medicare, Darnell noted.

"There is much to gain by integrating free clinics more formally into the healthcare safety net," she said. "But two things need to happen. Free clinics need to come out of the closet -- they are used to serving below the radar -- but at the same time, policymakers and other safety net providers need to acknowledge the valuable role that free clinics currently play."

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