Patient Transition From a Free Clinic to a Medical Home

ECHO is a student-run free clinic in the Bronx, NY. To address issues in continuity, ECHO transitioned in 2009 from indefinite care to providing patients with only two visits before transferring them to a traditional primary care facility. Diabetic patients who visited ECHO between 7/1/2009 and 6/30/2011 (n=25) were compared to a control group seen between 1/1/2007 and 12/31/2008 (n=25). We studied the transition’s effect on the establishment of a stable medical home by measuring percent of patients making follow-up visits according to guidelines. Patients who successfully transferred to a stable medical home were significantly older (56 vs. 46, p=0.0068). The transition policy made no significant difference on successful transfers ( p =0.3705), but there was a trend toward increased delay of subsequent visits ( p =0.0810). Further evaluation with a larger sample will help to clarify whether the new policy is detrimental to the establishment of a stable medical home, and why.