1. Safety Net Primary Care Demand and Supply Analysis April 2007
Community Clinics Advisory Committee (Alliance)
Project Safety Net (St. Luke’s Episcopal Health Charities)
Houston Health Services Research Collaborative (UTSPH)

2. Objectives Assess the overall gap in the County
Identify areas with the largest gap
Predict the impact of different strategies to close the gap

3. Estimated Demand
Obtain latest estimates of the number of uninsured at the ZIP code level from UTSPH
Obtain latest estimate of the average number of primary care visits per person per year from HCHD
Multiply the number of primary care visits by the number of uninsured in each ZIP code
Sum for the County and for each quadrant
Quadrants defined according to former HCHD service areas

4. Estimated Supply
Obtain latest estimate of primary care visits from Project Safety Net
70 clinics that provide free and/or discounted primary care at least 20 hours per week and serve as a medical home for the uninsured
Primary care visits defined as clinic encounter when patient seen by physician or mid-level practitioner

5. Limitations
Demand is overestimated since not all uninsured rely on safety net clinics for care
Supply overestimates capacity since patients use clinics outside their quadrant
Supply for the uninsured is based on unproven assumptions about payer mix
Unmet demand of the uninsured underestimates primary care capacity needed since clinics cannot survive if only serving the uninsured
Supply underestimates capacity since it does not include charity care of private physicians

8. 2005 Primary Care Gap for Total Uninsured

9. 2005 Primary Care Gap for Uninsured who are <100% of the Federal Poverty Level

10. 2005 Primary Care Gap for Uninsured who are <200% of the Federal Poverty Level

12. Growth in supply may only keep pace with population growth
Northeast quadrant growth in supply: 177,218 visits in 2005, 185,013 visits in 2006 (growth of 4.40%)
Northeast quadrant growth in population: 786,399 in 2000, 884,329 in 2005 (growth of 12.45%)

13. Population growth by quadrant and for entire county