Reducing non-urgent utilisation of the emergency department by the uninsured: analysis of the impact of a community-wide provider network

Post-EMTALA, proactive communities throughout the USA have strengthened their safety net systems to meet the healthcare needs of the ever-increasing uninsured population. This paper describes the evaluation of a community-wide initiative in Orange County, Florida to reduce non-urgent Emergency Department (ED) utilisation by uninsured patients through increased use of Community Health Centers (CHCs). National, state and local efforts designed to redirect uninsured patients from hospitals to CHCs for non-urgent care have been challenged by the complexities associated with evaluating effectiveness and quantifying community impact. This research provides a model to local communities and policy analysts for evaluating these initiatives.