Inside Duke Medicine

Providing care when it’s needed most

It’s hard to miss the stories in the news about the tragic impact the current global economic crisis is having on people and families locally and nationally.

North Carolina is being hit particularly hard by the downturn. The unemployment rate in our state has doubled over the previous year. One of the biggest concerns for people suffering the trauma of losing a job is continued access to health care services.

According to a recent estimate by the N.C. Institute of Medicine, about 1.8 million North Carolina adults, or about a quarter of all adults in the state, have no health insurance. The institute reported last month that the number of uninsured people in North Carolina is growing.

In these difficult times, Duke University Health System continues to step up and play a critically important role in providing care to those in greatest need.

In fact, in 2008 (the most recent year for which complete data are available), Duke University Health System provided uncompensated health care services and other direct community benefits in Durham, Raleigh and across North Carolina valued at $229 million.

“It’s important for all of us, throughout Duke Medicine, to understand that the health system provides a significant amount of care to the underserved, uninsured and underinsured each year,” said Victor J. Dzau, M.D., president and CEO of the health system. “And, this commitment is never more important than at a time when so many people throughout our state are being negatively affected by this global economic crisis.”

Approximately $141 million of the $229 million total fell under the federally defined categories of community benefit, which include urgent or emergent health care services provided at a discount or no cost to people in financial hardship, Medicaid program losses, direct support of community health organizations and the training of health care professionals in our hospitals and clinics.

In addition, DUHS also absorbed Medicare program losses and unrecoverable patient debt, which together totaled $88 million.

Just one part of these efforts, Duke’s support of community health organizations, affects two dozen community health programs that provide low-cost clinical services to more than 11,000 people. Among these is Duke’s direct and in-kind support of Lincoln Community Health Center, a federally qualified facility which serves an overwhelmingly poor and uninsured population in Durham.

Additionally, Duke supports primary care clinics in the Lyon Park and Walltown neighborhoods in Durham, operated in collaboration with Lincoln. Duke will do likewise at the future Holton Career and Resource Center, and in addition has provided support for design and construction.

Duke also funds and operates wellness centers in the George Watts, Glenn and E.K. Powe elementary schools and at Southern High School in Durham.

Duke specialists have made a commitment to health care access through their participation in the Project Access programs in Durham and Wake counties. Through Project Access, Duke faculty physicians donate their time and expertise to provide the uninsured with specialty care. The Durham County program grew out of Duke’s direct collaboration with Durham community leaders.

To communicate these efforts to the communities we serve, the health system has recently summarized its commitment to community benefit in a new publication that will be shared with elected officials and community leaders. This report will be made available electronically to employees and the public at large in coming weeks.

“Duke University Health System is committed to providing a free care program that exceeds industry standards and one that we should be proud of, as an organization,” Dzau said.