Executive Summary
The two counties that make up Kansas City–Wyandotte County, Kansas, and Jackson County,
Missouri–experience an approximated 15% uninsured rate (University of Wisconsin Population
Health Institute, 2021). Reasons for not having health insurance are often related to cost.
Amongst the uninsured, 73.7% do not have health insurance as a result of its cost-prohibitive
nature, and 41.5% had not seen a healthcare provider in over a year (Tolbert & Orgera, 2020).
Not having health insurance has been shown to decrease preventative services, exacerbate
chronic health conditions, and cause worse overall health (McWilliams, 2009). Unfortunately,
being uninsured has also been linked to premature death due to preventable causes
(Woolhandler, 2017). To address the disparity in healthcare access amongst the uninsured in
Kansas City, the JayDoc Clinic was created by the University of Kansas School of Medicine.
This location acts as a safety net clinic for individuals needing non-emergency urgent care at no
cost to the patient. The JayDoc Clinic has been serving the Kansas City community for over
seventeen years; however, it has never undergone a formal evaluation (University of Kansas
Medical Center, 2021). As a result, the objectives of the proposed evaluation are centered around
two groups, patients and volunteers. Evaluation objectives related to patients are to assess
whether patients are satisfied with the JayDoc Clinic and determine additional services they
would like to see implemented. Evaluation objectives for clinic volunteers are to determine if
volunteers at this clinic are satisfied with their experience and have any recommendations for the
clinic.
Introduction
Healthcare access remains a significant factor affecting the health of individuals living in
the United States. Frequently healthcare is avoided due to its cost-prohibitive nature. This places
individuals at increased risk for poor health outcomes. Preventive life-saving health screenings,
such as cervical and breast examinations, are often missed or skipped (Institute of Medicine,
2002). Without cost affordable options and locations, individuals are less likely to receive timely
care, resulting in worse health outcomes and potentially premature death (Office of Disease
Prevention and Promotion, 2014).
The greater Kansas City area is composed of two different counties that experience
unique needs; however, there is overlap regarding health insurance. Both Wyandotte and Jackson
Counties have a higher proportion of individuals who do not possess health insurance than in
their respective states. In 2018, the number of uninsured individuals amongst both counties was
approximately 15% (University of Wisconsin Population Health Institute, 2021). Furthermore,
from the most recent community health assessment, healthcare access was among the top five
problems facing individuals in Wyandotte County (Collie-Akers, et al., 2018).
To address the needs of the uninsured and underserved in the greater Kansas City area, a
safety net of clinics has been formed. These locations provide free or low-cost essential health
care services to individuals who do not have insurance or the ability to afford healthcare. In order
to continue to see patients, these locations must remain financially stable. To accomplish this,
clinics must constantly seek to manage costs while also increasing access, improving health
outcomes, and reducing hospitalization rates. Therefore, this evaluation of the JayDoc Clinic
aims to assess patients’ and volunteers’ satisfaction, what additional services may be beneficial
for a larger target population, and how the clinic may be improved to increase productivity.
Background and Significance:
Accessing healthcare remains a significant challenge that many individuals face in the United
States. In 2018, 8.5% of U.S. citizens, or 27.5 million individuals, did not have health insurance
at any point during the year, which increased from 7.9% or 25.6 million in 2017 (Census, 2019).
Unfortunately, individuals who do not have health insurance often avoid seeing physicians due to
the inability to pay, which may potentially worsen their health outcomes. In 2009, a study
demonstrated that nearly 45,000 deaths per year were attributed to lack of healthcare (Wilper et
al., 2009). To combat the disparity, the University of Kansas Medical Center (KUMC)
established the JayDoc Clinic. This free clinic located in Kansas City, Kansas, provides medical
evaluations and treatment for uninsured and underserved populations in a non-urgent care
setting. Free clinics, such as the JayDoc Clinic, serve an integral role in healthcare. These clinics
help bridge the gap in healthcare coverage and lessen the load on emergency departments by
providing care to patients who otherwise may not be able to be seen by a provider in a nonemergency setting (Birrs et al., 2016). Since its launch in 2003, the JayDoc Clinic has served
over 1,000 patients each year (University of Kansas Medical Center, 2021.). The goals and
mission of the JayDoc Clinic are to:
1. Provide quality healthcare to the uninsured populations of Kansas City,
2. Provide referrals to other community clinics, and
3. Improve student healthcare providers’ skills and competencies.
Problem/Need Statement:
The JayDoc Clinic strives to provide uninsured and underserved populations with free healthcare
services comparable to the national standard of care. However, patients’ satisfaction with the
clinic and input regarding additional health services are unknown. Currently, the JayDoc Clinic
does not report data on participant satisfaction or patients’ suggestions on additional health care
services that they would like to see implemented. Moreover, the JayDoc Clinic also does not
report on or collect information regarding volunteer satisfaction with the clinic or areas of future
improvement. This information is of utmost importance as individual experiences and input
remain essential tools for improving the JayDoc Clinic. Overall, evaluation can help the clinic
continue to effectively combat health disparities for those who do not possess health insurance
while also ensuring that volunteers and staff are satisfied with their experience.
Evaluation Questions:
1. Are JayDoc patients satisfied with the quality of care they receive?
2. What additional services would patients like to see implemented?
3. What do volunteers feel are areas of future improvement?
4. Are JayDoc volunteers satisfied with their volunteering experience?
Aim/Goal Statement: The purpose of this evaluation is to identify areas of improvement for the
JayDoc Clinic from both the patient and staff perspectives. Understanding the JayDoc Clinic’s
successes and areas of future improvement will allow the clinic to provide enhanced quality of
care for uninsured and underserved populations while ensuring that volunteers are also satisfied
with their experience.
Theoretical Foundation
For the evaluation of the JayDoc Clinic, the socio-ecological model will be utilized as the
theoretical foundation. The socio-ecological model posits that the model’s components and the
interdependence of these factors work to affect individuals’ health. The levels of the socioecological model include interpersonal (individual), organizational, community, and policy. The
overall goal of the JayDoc Clinic evaluation is to improve the clinic for patients and volunteers.
By focusing on this outcome, the evaluation process is targeting the community and
organizational factors of the socio-ecological model, which allows for the promotion of better
health for individuals within the community that utilize the JayDoc Clinic.
Figure 1: Socio-ecological Model (Okoye, 2020)
Evaluation Plan
As a result of the JayDoc Clinic’s goal to serve the uninsured and underserved, and due to this
location previously never being formally evaluated, this evaluation seeks to improve the clinic
structure and services for both patients and volunteers. Those who will directly benefit from the
evaluation of the JayDoc Clinic include the University of Kansas School of Medicine, the
JayDoc Clinic advisory board, JayDoc patients, and JayDoc volunteers. The goals of this
evaluation are to provide:
1. An evidence-based evaluation of current patients’ satisfaction
2. An evidence-based outline of current volunteers’ satisfaction
3. An evidence-based outline of recommendations for areas of future improvement
