The transfer of uninsured patients from academic to community primary care settings

To use the administrative capacity of a health maintenance organization to enroll uninsured patients at an academic health center into a coordinated care program in which patients were assigned to community primary care physicians over 3 years. Observational case study of a cohort of 2389 patients enrolled for at least 1 year and cross-sectional observations for all enrollees. Among 18,336 eligible patients enrolled in the program between January 1, 2001, and December 31, 2003, a total of 2389 patients were continuously enrolled before and after the inauguration of the program. Over the 3-year study, most of the eligible uninsured patients were successfully enrolled in community-based practices. For the cohort studied, reductions were observed in the proportions of enrollees with inpatient hospitalizations (17.6% vs 13.8%) and with emergency department visits (73.9% vs 42.9%) (P