A Cross-Sectional Study on Geographic Alignment of Student-Run Free Clinics with Medically Underserved and Underinsured Areas in the United States

Abstract

Introduction. Student-Run Free Clinics (SRFCs) have a dual mission of providing students with direct patient care experience while delivering no-cost services to patients. These clinics often serve as safety nets for individuals who might otherwise face barriers to care. By analyzing clinic locations in relation to Health Professional Shortage Areas (HPSAs), Medically Underserved Areas (MUAs), and county-level uninsured rates, we evaluated whether SRFCs are located in objectively defined areas of need.

Methods. We conducted a preliminary cross-sectional analysis using public datasets. Clinics were included if they appeared on the Society of Student-Run Free Clinics master list, were located in the United States, and provided specialty and/or primary medical care. Statistical analyses were performed using R software and included a one-sample t-test. Statistical significance was defined as p <0.05.

Results. We analyzed 194 clinics across 31 states and 91 distinct counties. Complete data were available for all clinics. Of the included clinics, 65.5% were located in primary care HPSAs and 58.5% were located in MUAs. Overall, 79% of clinics were located in either a primary care HPSA or an MUA. Counties with SRFCs had a significantly higher mean uninsured rate than counties without SRFCs (p = 0.002).

Conclusions. These preliminary findings suggest that SRFCs are disproportionately located in underserved areas and may be helping address unmet healthcare needs. However, results should be interpreted with caution. Future analyses will account for clustering and random effects associated with clinics nested within counties and states.