Continuity of Care in a Student-Run Free Clinic: Impact on Atherosclerotic Cardiovascular Disease Risk

BACKGROUND AND OBJECTIVES: Medical student-run free clinics (SRFC) provide underserved patients access to health care. Few studies have examined the effects of specific care models implemented by these clinics. We looked at the impact of a continuity of care delivery model on chronic care outcomes at an SRFC sponsored by Ohio State University College of Medicine. METHODS: Using the SRFC electronic medical records, we abstracted health records of patients at risk for atherosclerotic cardiovascular disease (ASCVD). We formed three study groups matched on age and gender. Group 1 were the patients enrolled in a continuity of care program, Group 2 were patients who visit the SRFC at 3-month intervals, and Group 3 were sporadic visitors. Authors compared groups' ASCVD risk score change over 12 months using a Group x Time Analysis of Variance. RESULTS: We identified 81 subjects that met the qualifications for this study and assigned them to one of the three study groups. A Group x Time interaction showed that mean ASCVD risk scores improved significantly for continuity of care patients and regular visitor controls, but not for sporadic controls (F=3.82; df=2/1.72; P=.035; es=1.28). CONCLUSIONS: This SRFCs continuity of care delivery had no appreciable impact on lowering ASCVD Risk scores over and above frequent regular visits to the clinic. This finding suggests that SRFCs should focus on getting their chronic patient population to maintain a schedule of frequent check-ups, without investing in continuity of care. Longer-term studies are needed to detect a continuity of care delivery model effect.