Moving forward, we are most interested in pursuing research projects that directly investigate the efficacy of the CURE model. More specifically, we want to engage in work that centers around determining the usefulness of our clinic for the underserved, the barriers our patients regularly experience when trying to access medical care, and the financial benefits of implementing this model of care. Long-term, we seek to increase our resource base, expand our outreach, and continue to address structural inequalities in our healthcare system with cost-effective measures that are easy to implement and extrapolate to other healthcare institutions in other American cities.
Economic Assessment of Expanding Otolaryngology Services to Chicago’s Homeless Community in a Free Clinic
Abstract below, manuscript in progress
Introduction
Unhoused patients face substantial barriers to outpatient otorhinolaryngologic (ENT) care, resulting in frequent emergency department (ED) visits and elevated healthcare costs. Free specialty clinics such as Rush University’s Center for the Underserved at Rush ENT (CURE) can improve access to ENT care for underserved persons and homeless communities in Chicago. This study examines ENT presentations among unhoused patients to the Rush University Medical Center ED during fiscal years (FY) 2024-2025 to identify care patterns and opportunities to reduce these costs.
Methods
A retrospective review was performed of ED encounters for homeless patients with ENT-related complaints during FY2024 (July 1, 2023-June 30th, 2024) and FY2025 (July 1st 2024 - July 1st 2025). Encounters were cross-matched with fiscal year reports to estimate treatment costs.
Results
A total of 379 patients accounted for 767 ENT-related ED encounters (412 in FY2024; 355 in FY2025). Mean patient age was 43.8 years (SD=15.58) years; 62.8% were male and 65.2% identified as Black or African American. Most patients (55.7%) had managed care insurance, which coordinates care through provider networks and utilization controls. Common presentations included upper respiratory infections (16.6%), viral pharyngitis (12.7%), and nasal congestion (11.9%). Patients averaged 2.04 visits (SD=2.55), with a mean length of stay of 32.3 hours (SD=74.3). Mean charge per encounter was $5,320 (SD=$3,335) and the mean direct cost was $547 (SD=$339), totaling $4,080,188 in charges and $418,281 in direct costs.
Conclusions
This study highlights the potential of free specialty clinics to improve access to ENT care while reducing ED burden, associated healthcare costs, and ensuring patients receive care aligned with appropriate patient acuity.