Dissertations, Theses and Capstone Projects

Date of Award

Fall 12-2009

Degree Type


Degree Name

Master of Public Administration (MPA)


Political Science


The purpose of this study is to analyze data from Cobb County safety net facilities to determine primary and specialty care accessibility for low-income patients as evidenced by the availability of resources, affordability of services, accountability of quality care, and policies for the uninsured. The study provides insight for assessing the circumstances in Cobb County and supplies information on services that may need evaluation and expansion. Data for safety net facilities were obtained through interviews with a questionnaire that consisted of 13 dichotomous questions, 10 closed-ended questions and 2 open-ended questions. All the executive administrative staff or chief executive officers from safety net facilities in Cobb County participated in the survey.

First, the accessibility of providers and limited hours of operations compared to the number of uninsured residents in Cobb County is very small. This means an excessive number of patients are forced to visit the emergency room departments, even for minor conditions. Moreover, phone access to a primary care provider is attainable at only one of the community health clinics.

Second, the lack of tracking primary language along with unanimous reports on interpreting needs is a significant finding. The U.S. Census Bureau’s American Community Survey estimates that Cobb County has 114,280 persons (age 5 and older) who speak a language other than English. The 2005-2007 American Community Survey also estimates that 22,626 Latinos did not consider themselves Mexican, Puerto Rican or Cuban. Chief executive officers and executive directors report that the second most common interpretation need is for Portuguese speaking patients. An increase in Centraland Southern American residents may have resulted in this need. Seeing the trend across organizational lines can help Community Health Centers (CHCs), emergency departments, and all healthcare providers plan for the future needs.

Third, the outreach services provided showed that 71 percent of the participants had a Drug and Alcohol Program. Perhaps these programs emerged from federal requirements, and physicians seeing a need, or from an increased diagnosis of disease. Further study on the goals, participation, and outcomes of these programs would be advantageous. Additionally, 86 percent of the participants provided optional spiritual support to their patients. The executive directors expressed the benefit of these varying programs to their patients. In sum, an in-depth analysis of these programs would also be valuable to health leaders and public policy makers.