The effect of free primary health care access on health services utilisation by a socioeconomically disadvantaged patient population: A controlled before-and-after study.

niversity of Otago0 个研究点目标入组 400 人开始时间: 2013年8月30日最近更新: 2020年1月13日

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•Enrolment at Dunedin's free clinic. A gatekeeping role is performed by the practice manager: criteria for enrolment include possession of a current Community Services Card (CSC, which is means-tested), and a variety of social vulnerability characteristics such as having a mental illness, substance abuse, an imprisonment record, prior child abuse. There is a degree of discretion with regards to the latter. Therefore, enrolment at the free clinic is implicitly associated with both socioeconomic deprivation and social vulnerability.

•Not being resident in Dunedin prior to enrolment at the free clinic. Since there is almost certainly no fully appropriate comparator group, even among patients at Dunedin clinics serving low income catchment neighbourhoods, the primary outcome (secondary care usage) is being compared for free clinic patients pre- and post-enrolment (constituting in essence a before-and-after study). For this reason, study participants need to be resident in Dunedin during the pre-enrolment phase of the study period.

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