There is a lack of understanding of adult primary care resources in New Haven, which has a growing population of Medicaid patients as a result of the expansion of this program under the Affordable Care Act.
As part of their training in the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program, a group of Yale investigators set out to better understand access to primary care in New Haven and surrounding communities through a community-based participatory research project.
Jason Lott, M.D.; Arjun Venkatesh, M.D., M.B.A.; Jennifer Voorhees, M.D.; and Ilse Wiechers, M.D., worked with five community organizations to develop a 78-item survey of factors that affect access to adult primary care. They collected data from over 90 percent of the 98 adult primary care sites in New Haven and four surrounding towns.
The results reveal both barriers and opportunities in access to primary care. Only about half of primary care providers accept new Medicaid patients and the majority require photo id, a barrier for many patients. The majority of practices uses electronic health records and has entries that are wheelchair-accessible, but only a third has a counter height that is wheelchair-accessible.
The scope of the project includes sharing the results in meetings with the participating community organizations; delivering feedback to individual practices; producing a report for the community; and using the data and advocacy efforts to obtain funding for further research. It also has the potential to serve as a model for a statewide primary care assessment. The group hopes to create an online resource catalogue and administer a similar survey to pediatric practices in the community.