Perspectives on Transitioning Uninsured Persons from an Emergency Department to Federally Qualified Health Centers in East Baltimore

Abstract

Many people in the United States rely on the emergency department (ED) for their usual source of primary care. Linking these ED users to a source of longitudinal primary care could provide significant health benefits. To assess an intervention attempting to connect ED users to federally qualified health cents (FQHCs), we conducted semi-structured, in-depth interviews with volunteers, health facility providers, and a patient and a focus group with program volunteers. All sessions were digitally recorded, transcribed and analyzed to develop emergent themes highlighting the barriers and facilitating factors that affect the process of connecting patients to primary care. Themes included that 1) the ED is the preferred source of primary care over FQHCs, 2) there are limited links between EDs and FQHCs and 3) the evaluated intervention acts through and depends on patients’ prioritization of health and access to resources. Our findings suggest that, in addition to addressing individual needs, social services programs are well positioned to help increase communication between providers at FQHCs and EDs about both the services available to patients and patients’ medical care histories.