The Impact of Free and Charitable Clinics in Virginia

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ASSIGNMENT Assignment 1 – Research Project Statement Purpose – Offer insight into the nature of the research project, what is being investigated, and the topic’s significance to the field of HCA. This assignment continues the work done during the Fall 2018 HCA 300 course. It is an abbreviated version of Assignment 7 (Fall 2018) * Format (use subheadings for each section) 1) Title/Topic of research project – also include why you chose this topic; and the purpose behind the research 2) Research question being asked (and an explanation in detail of the relationship under investigation; what is being measured and how) 3) Research methodology – What is it and how will this help answer the Research Question (explain in detail) – tools of analysis to be utilized – contingency plan explained (Backup plan) 4) Significance of topic to HCA – how it advances our understanding of the field of HCA 5) Surveys/Interviews (if being used) to be attached. 6) Preliminary Reference list showing review of literature up to this date – with a minimum of 35 references (books, articles, etc.) *Sources – scholarly works only * Length 3 pages. (not including Reference list and surveys/interview instruments) double spaced * Due Date – January 18, 2019 Running head: Impact of Free and Charitable Clinics in Virginia on Access to Healthcare Impact of Free and Charitable Clinics in Virginia on Access to Healthcare 1 Impact of Free and Charitable Clinics in Virginia on Access to Healthcare 2 Impact of Free and Charitable Clinics in Virginia on Access to Healthcare Purpose The purpose of the proposed research study is to analyze the impact of free clinics on healthcare access in Virginia. It will investigate to find out whether the free clinics are undertaking their role in serving the uninsured and underserved patients in the State and whether they are distributed to cover all the uninsured people across Virginia. The study will mainly focus on the uninsured and underserved populations in the State given that these are the people who largely use free clinics. Free healthcare clinics are essentially volunteer-based healthcare organizations providing health care services at minimal cost or for free of charge to people who are of lowincome (Hutchison et al., 2018). They are an important avenue for addressing the medical needs of people who have no health insurance coverage. Even though they often lack the resources for meeting all the medical needs of people they serve, free healthcare clinics usually deliver care for chronic conditions and diseases by means of dispensing drugs, regular monitoring, as well as performing laboratory tests (Hutchison et al., 2018). The healthcare services they offer might be more limited compared to the ones provided by the mainstream healthcare organizations which accept insurance largely because they depend on administrative and medical volunteers, and also have limited funding (Nadkarni & Philbrick, 2013). Although free healthcare clinics in America lack services, organizational structure, as well as crucial resources in comparison to the mainstream healthcare organizations, Gertz, Frank and Blixen (2011) mentioned that they still play a very significant role in the country’s healthcare delivery system. At the moment, not much is known regarding the impact of free clinics on access to healthcare in spite of the fact that such clinics are among the few possible alternatives for uninsured and underserved Americans who have limited funds. Impact of Free and Charitable Clinics in Virginia on Access to Healthcare 3 Research Question The study seeks to address the following overarching research question: How do free and charitable clinics in Virginia impact access to healthcare? Through this research question, the study will aim to establish whether free and charitable healthcare clinics in the State of Virginia would increase or decrease the number of patient visits to the free clinic. The research question will also help to understand the kinds of medical and health conditions that the free and charitable healthcare clinics in the State will mainly manage in terms of the severity of the conditions treated by the clinics, number of referrals to such healthcare clinics, as well as the number of new cases diagnosed. Furthermore, the overarching research question is important as it will help understand the demographics of people in terms of characteristics such as education, race, socio-economic class, gender, and age who will lose the most or benefit the most with those free healthcare clinics. Research Methodology Regarding, the research methodology, the proposed study will use a mixed methods research methodology. This will entail collecting both quantitative and qualitative data. This type of methodology generally involves collecting and analysing both close-ended and open ended data (Creamer, 2017). It is appropriate for the proposed study in that by combining the qualitative and quantitative approaches, the study will be able to gain in depth and breadth of corroboration and understanding of the subject matter and offset the weaknesses inherent in each research method when used individually (Pepe & Castelli, 2013). The mixed methods research design will also be utilized since the mixing of the two methods will allow the researcher to understand the research problem better than when the qualitative or the quantitative approach is used alone (Han, 2018). In addition, this research method will facilitate triangulation whereby the same phenomenon would be examined through various methods and data sources (Howell, 2013). Impact of Free and Charitable Clinics in Virginia on Access to Healthcare 4 Quantitative data would be collected from records of distribution of uninsured and low-income populations in Virginia in relation to distribution of the free clinics in the State. Additionally, raw data would be obtained from health records of the free clinics. The quantitative data will be obtained through the use of a map that locates all the free clinics in Virginia and maps to reveal the locations of people who are uninsured and underserved. Conversely, qualitative data will be collected through interviews with directors and administrators of the free clinics in Virginia who comprise the target population. The researcher will conduct one on one interview through Skype, phone calls, or in person. Since this is a mixed methods research, data analysis will entail using both quantitative and qualitative techniques for data analysis (Morgan, 2014). Quantitative data will be analyzed through descriptive statics such as mean, variance, median. Correlation analysis will then be used to determine the strength of relationship between cost of healthcare and accessibility. Also, linear regression analysis would be used to determine the relationship between free health services and quality of services using the best fit straight line. In this regard, linear regression equation will be used to predict the impact of free and charitable clinics in Virginia on access to healthcare. The qualitative data is consisting of interview transcripts would be analyzed by categorizing the data and comparing them with the quantitative data (Smith & Zajda, 2018; Chu & Ke, 2017). Primary and secondary sources of data play an integral role in the proposed study. Primary sources such as interviews will offer a first-hand account of the subject under study (Short, 2014). They will allow the researcher to understand how the directors of free clinics in Virginia think their clinics are impacting access to healthcare within the State. The primary sources will represent original information. They will provide first-hand or direct evidence of the subject matter (Garbarski, 2016). On the other hand, secondary sources used Impact of Free and Charitable Clinics in Virginia on Access to Healthcare 5 in the proposed study will offer a restatement, interpretation or analysis of the primary sources (Adams, 2013). The mixed methods research methodology will help answer the research question. The quantitative data will enable the researcher to establish whether the clinics are covering the uninsured populations or not. The data will comprise several demographics of patients and divide the uninsured people on the basis of characteristics such as ethnicity, gender, education and age. The analysis of quantitative data will reveal the strength of relationship between cost of healthcare and accessibility as evidenced by increase or decrease in number of visits and number of volunteer staffs coming to the new clinics. It will also demonstrate the relationship between free health care services and quality of services. The interviews will aim to explore the topic from the perspective of healthcare providers. The providers will answer a number of questions about some of the issues concerning quality and funding. In this way, the research methodology will effectively help address the specified research questions. The location/site of the research will be four clinics within the State of Virginia. These are clinics that offer free healthcare services to underserved and uninsured populations. Virginia was selected as it has significant health disparities and there are also a number of free clinics in operation (Mcgarvey et al., 2011). Additionally, Virginia was selected for the study because it is my primary residence. Also, Working in Virginia’s free clinics as a volunteer and an intern aroused the interest in the mission of these clinics and therefore establishing whether or not they are making any impact on access to healthcare. Since these free clinics often attract a large number of low-income people, there is likelihood that they have a positive impact by increasing access to healthcare especially to low-income groups In the proposed study, e-research will play a crucial role since advanced Information and Communication Technologies would be utilized in supporting the research (Anderson & Impact of Free and Charitable Clinics in Virginia on Access to Healthcare 6 Kanuka, 2013). Ethical aspects would be taken into account when conducting the research. The following five fundamental principles of research would be observed: firstly, confidentiality and anonymity of the study subjects would be protected (Pulverer & Armbruster, 2017). Secondly, informed consent would be obtained from the respondents. Thirdly, deceptive practices would be avoided. Fourthly, the risk of harm would be minimized. Lastly, the study subjects would be provided with the right to withdraw their participation (Stanley, Sieber & Nelton, 2014). Some theories indicate that increasing equity, for instance by increasing the number of free clinics, will affect access to healthcare (Petrany et al., 2017; Birs et al., 2016). Over the past several years, free clinics have emerged across the country in response to limitations in healthcare together with an intransigent uninsured problem (Darnell, 2011; Pieh-Holder, Callahan & Young, 2012). Theoretically, the utilization of health-care should correlate with the need for services (Darnell, 2011; Biello et al., 2010). Even so, some crucial healthcare services are required but not obtained owing to cost implications (Levesque et al., 2013; Johnston, Peppard & Newton, 2015). At the moment, it is unclear how free and charitable clinics impact the access to healthcare (Rubin, 2017; Zucker at al., 2013). As such, examining the impact of free clinics will help to fill this gap in extant literature. Significance to the Field of Health Care Administration This proposed study is significant to the field of health care administration given that following the passage of the Affordable Care Act in the year 2010 by the administration of President Obama, there has been a considerable increase in the number of uninsured people across the nation. These people have greatly overwhelmed care delivery with the free and charitable clinics playing a vital role in bridging the access to healthcare (Gertz, Frank & Blixen, 2011; Hutchison et al., 2018).Such clinics employ staffs and volunteers to offer necessary medical services to many individuals who cannot afford care without needing any Impact of Free and Charitable Clinics in Virginia on Access to Healthcare 7 form of payment (Ghazal & Rambur, 2018; National Association of Free and Charitable Clinics, 2014). The study will therefore reveal how these clinics are impacting the access to healthcare for the country’s uninsured and underserved populations. In addition, the topic is significant since the study will provide a guideline for healthcare policy implementations that may be advanced to manage the challenges of healthcare in Virginia and other States nationwide. The topic is also significant to the Field of Health Care Administration since the health outcomes for people who are underserved and who are uninsured are considerably poorer in comparison to those of Americans who are privately insured (Geller, Taylor & Scott, 2011). Populations that are underserved generally receive lower quality medical care as well as less medical care. Given that a large number of patients, particularly those with limited funds, are not able to pay for various health care services themselves, Geller, Taylor and Scott (2011) stated that public health initiatives have to connect people with local resources which would facilitate access to the health care needed by those people. Free healthcare clinics which deliver medical care inexpensively or freely to people who are underinsured or uninsured are a crucial resource for Americans across nationwide who are underserved (Kaiser Family Foundation, 2013). Even though it is important to pay attention to the healthcare quality that such clinics offer, they have demonstrated that they are a vital aspect of the healthcare safety net for people who are disadvantaged (Geller, Taylor & Scott, 2011). Previous studies have found that people who lack health insurance have a higher likelihood of reporting problems receiving necessary medical care compared to people who are insured (Geller, Taylor & Scott, 2011). About 25% of uninsured adults went without getting the needed medical care in 2012 owing to cost (Kaiser Family Foundation, 2013). The main reason for poor access amongst uninsured Americans is that over 50% of uninsured Impact of Free and Charitable Clinics in Virginia on Access to Healthcare 8 Americans lacked a regular place to go to whenever they needed medical advice or when they are ill (Kaiser Family Foundation, 2013). Over time, healthcare has become less affordable especially for people who are uninsured, underinsured, and underserved thanks to the growing costs of healthcare. Furthermore, Americans who are not insured have a less likelihood of receiving timely preventive care compared to those who have insurance coverage (Kaiser Family Foundation, 2013). Therefore, the importance of free healthcare clinics cannot be overemphasized, especially for the underinsured, underserved, and uninsured. Limitations The proposed study has quite a few limitations. Firstly, it will only be carried out only within one State, namely Virginia. Also, a small sample size would be used since only four directors of clinics in Virginia that offer free healthcare services would take part as study subjects. The fact that the study would be carried out in just a single State and very few participants will participate suggests that the findings may not be generalizable to the general population (Wilson, 2016). The other limitation is that the mixed methods research could be extremely complex to conduct (Ingham-Broomfield, 2016). Planning and implementing this sort of research requires much more resources and time than only conducting a quantitative or qualitative study (Sweeney & Goldblatt, 2016). Furthermore, it might not be clear how to resolve discrepancies arising in the interpretation of the results (Venkatesh, Brown & Sullivan, 2016). Impact of Free and Charitable Clinics in Virginia on Access to Healthcare 9 References Adams, J. (2013). Research Methods for Graduate Business and Social Science Students. New Delhi: Sage Publications Pvt. Ltd. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=278216&site=eh ost-live Anderson, T., & Kanuka, H. (2013). e-Research: Methods, strategies and issues. Boston, MA: Allyn & Bacon. Biello, K. B., Rawlings, J., Carroll-Scott, A., Browne, R., & Ickovics, J. R. (2010). Racial disparities in age at preventable hospitalization among US adults. American journal of preventive medicine, 38(1), 54-60. Birs, A., Liu, X., Nash, B., Sullivan, S., Garris, S., Hardy, M., . . . Pasarica, M. (2016). 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