Frequently Asked Questions About the Urban Health Initiative

• What is the Urban Health Initiative?
• Why is the UHI necessary?
• What is the goal of the UHI?
• What is the South Side Health Collaborative?
• What are the other components of the UHI?
• How much is UCMC investing in UHI?
• What patients are most impacted by the UHI's efforts?
• How does UCMC benefit from an initiative like the UHI?
• Is UCMC's situation similar to those of other academic medical centers located in urban settings?
• How many community health centers and hospitals does UCMC consider to be part of UHI?
• What do South Side residents think about UHI?
• Even though UHI is in its very early stages, can you point to encouraging results?

Q. What is the Urban Health Initiative?
A. The Urban Health Initiative (UHI) is a collaboration between the University of Chicago Medical Center (UCMC) and community doctors, nurses, health centers and hospitals to improve the long-term health of South Side residents. Together, we’re creating a better health care network in which patients can get the right care at the right time in the right place.

The UHI is a multi-faceted program that includes patient care, education of medical students in community settings and research taken directly to our residents -- all aimed at helping improve the health status of our surrounding population, one of the least healthy in the nation. We are marshaling our financial, intellectual and public policy assets to develop a true health care network that is connected to the community and that all patients can access.

Q. Why is the UHI necessary?
A. The South Side community, made up of one million people in more than 30 neighborhoods, has a critical need for quality health care. It has alarmingly high rates of diabetes, asthma, hypertension and other chronic conditions.

Q. What is the goal of the UHI?
A. The cornerstone of the UHI is helping people find a "medical home" -- a place in the community where they can get effective care for both prevention and treatment of non-urgent conditions, routine care and management of health issues and be referred to specialists or hospitals for more complex care.

Currently, 25 percent of patients who come to the UCMC emergency room do not have a medical home or a primary care physician. These patients are not receiving routine preventative care, early detection or consistent disease management. The UHI aims to provide the right care at the right time in the right place.

Q. What is the South Side Health Collaborative?
A. The South Side Health Collaborative (SSHC) is one component of the UHI. The SSHC was created in 2005 to help emergency room patients with non emergency conditions find appropriate primary care and establish an ongoing relationship with a community clinic or physician, also known as a "medical home."

Q. What are the other components of the UHI?
A. The Urban Health Initiative is multi-faceted program that draws on the financial, intellectual and public policy assets of UCMC to improve long-term community health. In addition to helping ER patients find more effective short-term and long-term care through the SSHC, the UHI includes:

• Grants to expand capabilities of our partners
• Supporting underutilized hospitals on the South Side and providing UCMC doctors to care for patients in those settings
• Encouraging alumni to practice in surrounding, underserved communities
• Conducting research to learn how to provide more effective community health care
• Helping community health centers serve as a medical home for patients from their community
• Advocating health care policies at the state and federal levels

Q. How much is UCMC investing in UHI?
A. UHI is a serious effort to improve health care in our community … and it involves a serious commitment of resources -- financial, intellectual and academic. To date, UCMC has invested more than $8 million in the effort. Here is a partial list of UHI investments and activities:

• We delivered a $350,000 grant to Access Community Health -- our largest health center partner -- to build out and expand its Grand Boulevard location near campus.
• We have more than 60 UCMC doctors providing care at community health centers and hospitals on the South Side. They are primary care physicians and doctors who specialize in areas of greatest need for South Side patients: cardiology, infectious disease, children’s asthma, etc.
• A team of UCMC physicians is based at Mercy Hospital to provide inpatient care for patients who were initially treated at UCMC’s ER, but do not need to be in the high-tech, high-intensity setting of UCMC. There is a dedicated 14-bed unit at Mercy, staffed by U of C doctors.
• UCMC moved its psychiatric inpatient unit, including the faculty physicians who staffed it, to Mercy. Mercy has always offered in-patient psychiatric services and in-patient substance abuse services. By combining UCMC’s and Mercy’s programs, the overall psychiatric in-patient program is enhanced.
• We are collaborating with obstetrics providers on the South Side to handle routine prenatal care and deliveries so that UCMC can concentrate on higher-risk and more complicated pregnancies.
• UCMC has invested $150,000 in Friend and Family Health Center for renovations.
• UCMC has invested $150,000 in Chicago Family Health Centers to support their maternal and child health program.
• UCMC created a $40,000 a year financial aid program for medical school graduates to practice in South Side neighborhoods once they have completed residency.

Q. What patients are most impacted by the UHI’s efforts?
A. Our goal is to help ER patients without primary care by connecting them with long-term medical homes. The effort is payer-blind, which means that we are trying to find medical homes for patients whether they are rich, poor or middle-income … insured, uninsured or covered by Medicaid or Medicare.

Q. How does UCMC benefit from an initiative like the UHI?
A. UHI is about managing health resources -- UCMC’s and society’s -- so that there is improved access to health care in our community. For UCMC, that means managing resources and costs in a way that satisfy three missions -- patient care, biomedical research and physician education. Each is connected to the other and each imperative for an effective system of care.

In practical terms, we are working to make sure that UCMC doctors and beds are available when very complex treatments are needed and that we have financial wherewithal to find cures for disease; invent new diagnostics and therapies; and train new doctors and researchers.

Q. Is UCMC’s situation similar to those of other academic medical centers located in urban settings?
A. Many academic medical centers reside in urban areas that face similar challenges, and they are searching for their own solutions. UCMC circumstances probably pose greater challenges than most because UCMC is located in such a large and profoundly disadvantaged urban setting.

The 1.1 million residents of South Side Chicago suffer unacceptably high rates of hypertension, diabetes, asthma and other chronic diseases. For example, area residents over 35 years old are three times more likely than the state average to be hospitalized for complications of diabetes. This rate could be dramatically reduced if patients had medical homes and were subject to ongoing primary care.

The South Side has been dealing with another major complication, namely the deteriorating financial health of the area’s health care providers. The neighborhoods cannot afford to have large providers go out of business like Michael Reese did last year. The loss of beds and medical resources directly and adversely affects the ability of UCMC and other hospitals to provide access to the right care at the right time in the right setting.

Q. How many community health centers and hospitals does UCMC consider to be part of UHI?

A. We collaborate with almost 20 local community health centers and hospitals … and we hope to expand the group as time goes on. Happily, there are many highly qualified providers in the area, including nearly 600 physicians on the South Side. The point is, there are significant resources available and we are going to work very hard to incorporate them into a truly effective system of care for the community.

Q. What do South Side residents think about UHI?
A. In 2006, we asked a cross section of 600 South Side residents about UHI. We explained to them that our plan was to help as many local residents as possible -- no matter what they are able to pay -- connect to doctors and health centers in their neighborhood on a regular basis for check-ups, health screenings, and care for their health needs; and that the plan would require that UCMC and other community health providers share resources and doctors, nurses, and other health professionals to improve the quality of care available in the neighborhood clinics. Four out of five people (81 percent) looked favorably on the idea.

In that same survey, we learned that 64 percent of area adults were not aware of any health centers in the community where they could see a doctor if they did not have insurance. The lack of awareness is another reason for wanting to pursue UHI. If more people knew where to go for care and reduce their reliance on the ER, community health and community health care would benefit greatly.

Q. Even though UHI is in its very early stages, can you point to any encouraging results?
A. There are some encouraging signs. Last year, for instance, we treated fewer non-urgent care cases in our ER -- non-emergency patients dropped from 40 percent to 34 percent. That means the ER was doing more of what it is intended to do: treating urgent medical needs.

At the same time, non-urgent patients -- many with chronic health problems and risky health behaviors -- were referred to other UHI collaborators and got better care. For example, of the patients we referred:

• Thirty-eight (38) percent had been seen two or more times by a primary care provider other than UCMC and 67 percent had had a general physical exam.
• Seventy-nine (79) percent of patients with hypertension were taking regular medication to treat their condition.
• Forty six (46) percent identified as smokers had enrolled in smoking-cessation programs.
• Fifty-two (52) had their cholesterol checked.

More Information

• UHI Video
• About the UHI
• What People Are Saying
• Frequently Asked Questions
• UHI Newsroom