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Characteristics of Patients with Dermatologic Conditions in a Student-Run Free Clinic: A Retrospective Study 学生开办的免费诊所中皮肤病患者的特征:一项回顾性研究
Pub Date : 2023-08-29 DOI: 10.59586/jsrc.v9i1.401
Alexander M Hammond, Kristin N. Smith, Macartney Welborn, Victoria Dukharan, Anshul Daga, Chloe Warpinski, Oliver T. Nguyen, K. Motwani, K. Motaparthi
Background: The Equal Access Clinic is a free, student-run clinic affiliated with the University of Florida in Gainesville, Florida. Four days a week, a general clinic is held at various sites, providing free healthcare to patients in North Florida. Once a month, a specialty clinic for dermatology is held based on a referral system from general clinics. We aimed to characterize patients’ demographics and diagnoses who received dermatologic care at a free clinic in North Florida. Methods: A retrospective chart review was completed for patients seen at Equal Access Clinic for a dermatology diagnosis from 2013 to 2020 (n=864). Results: One third of patients were seen for a chronic dermatology condition. Patients who were white and higher earners were more likely to travel further distances for care. Conclusions: These findings highlight the importance of improving access of dermatology care to underserved areas and may be accomplished in part by increasing access to transportation to clinics. Limitations include the retrospective nature of our chart review and the reliance on zip code to estimate median household income. Additionally, the patients in this study were seen by primary care physicians, rather than dermatologists.
背景:平等机会诊所是一个免费的,学生经营的诊所,隶属于佛罗里达州盖恩斯维尔的佛罗里达大学。每周四天,一个普通诊所在不同地点举行,为北佛罗里达的病人提供免费医疗保健。每月举行一次皮肤科专科门诊,以普通诊所的转诊制度为基础。我们的目的是描述在北佛罗里达一家免费诊所接受皮肤科治疗的患者的人口统计学特征和诊断。方法:对2013年至2020年在平等机会诊所就诊的皮肤病学诊断患者(n=864)进行回顾性图表回顾。结果:三分之一的患者就诊为慢性皮肤病。白人和高收入的患者更有可能走更远的路去看病。结论:这些发现强调了改善服务不足地区皮肤科护理的重要性,可以通过增加到诊所的交通来部分完成。局限性包括我们的图表回顾的回顾性性质和依赖邮政编码来估计家庭收入中位数。此外,在这项研究中,患者是由初级保健医生,而不是皮肤科医生。
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引用次数: 0
COVID-19 Testing and Resources for Underserved Communities in Rural Tijuana 蒂华纳农村服务不足社区的COVID-19检测和资源
Pub Date : 2023-08-08 DOI: 10.59586/jsrc.v9i1.391
J. Penn
Flying Samaritans at the University of California, Los Angeles (UCLA) is a 501(c)(3) nonprofit, undergraduate student-led organization which provides medical and dental care, prescription medications, and health education resources free-of-cost to two underserved, rural communities in Tijuana, Mexico. Free Coronavirus Disease 2019 (COVID-19) testing is not widely accessible in Tijuana. Pandemic-related job loss and high rates of financial instability in the communities create financial barriers which limit COVID-19 test accessibility. The COVID-19 Resources Project was developed to provide free, on-site COVID-19 rapid tests to patients at Flying Samaritans at UCLA’s monthly clinics. This project also offers reimbursement for the roundtrip cost of transportation to vaccination sites for patients who lack access to their own method of transportation, in order to eliminate barriers to getting vaccinated. Lastly, partnerships created with non-profit organizations funded this project and allowed for the provision of additional resources to the patient population. Details regarding this program’s development are provided in order to assist student-run free clinics which may be looking to start their own rapid testing and/or grant-funded projects. Lastly, COVID-19 testing is planned to continue into the future.
加州大学洛杉矶分校(UCLA)的飞行撒玛利亚人是一个501(c)(3)非营利组织,由本科生领导,为墨西哥提华纳两个服务不足的农村社区免费提供医疗和牙科护理、处方药和健康教育资源。免费的2019冠状病毒病(COVID-19)检测在蒂华纳并不普遍。与大流行相关的失业和社区的高金融不稳定性造成了财务障碍,限制了COVID-19检测的可及性。“COVID-19资源项目”旨在为加州大学洛杉矶分校每月诊所的“撒玛利亚飞行会”的患者提供免费的现场COVID-19快速检测。该项目还为无法使用自己的交通工具的患者报销前往疫苗接种地点的往返交通费,以消除接种疫苗的障碍。最后,与非营利组织建立的伙伴关系为该项目提供了资金,并为患者群体提供了额外的资源。提供有关该计划发展的详细信息是为了帮助学生经营的免费诊所,这些诊所可能正在寻求开始他们自己的快速测试和/或资助项目。最后,计划在未来继续进行COVID-19检测。
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引用次数: 0
Patient Satisfaction and Healthcare Seeking at Three Free Clinics 三个免费诊所的患者满意度和医疗保健寻求
Pub Date : 2023-07-13 DOI: 10.59586/jsrc.v9i1.362
Brendan Wheeldon, John Petrilli
Background: Patient satisfaction is an important metric that has been associated with social determinants of health and multiple health outcomes. However, limited studies have been conducted at free clinics, particularly comparing multiple clinics. Methods: This study surveyed patient satisfaction at three free clinics in Tampa, Florida. A written survey was distributed to patients at the clinics over 6 weeks. Results: Satisfaction was generally high among the clinics, with patients from the student-run free clinic reporting the highest satisfaction. There was no significant difference in satisfaction scores among the clinics after adjusting for socioeconomic variables. Despite high satisfaction scores, only 58.8% of patients reported coming to clinic for a general check-up, and only 20.1% reported coming for a cancer screening test. Conclusions: The differences between clinics were attributable to demographic factors, highlighting the importance of considering social determinants of health when discussing satisfaction. Patients at the free clinics in this sample reported high satisfaction with their care, but self-reported low receipt of preventative care. The results may indicate that patients at free clinics would benefit from education about free clinic services and what constitutes quality healthcare.
背景:患者满意度是与健康和多种健康结果的社会决定因素相关的重要指标。然而,在免费诊所进行的研究有限,特别是比较多个诊所。方法:本研究调查了佛罗里达州坦帕市三家免费诊所的患者满意度。在6周的时间里,向诊所的患者分发了一份书面调查。结果:各诊所满意度普遍较高,学生自办诊所满意度最高。在调整社会经济变量后,各诊所的满意度得分无显著差异。尽管满意度很高,但只有58.8%的患者报告来诊所进行一般检查,只有20.1%的患者报告来做癌症筛查测试。结论:诊所之间的差异可归因于人口因素,强调在讨论满意度时考虑健康的社会决定因素的重要性。在这个样本中,免费诊所的患者对他们的护理非常满意,但自我报告的预防性护理的接受程度很低。结果可能表明,免费诊所的患者将受益于免费诊所服务和什么是优质医疗保健的教育。
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引用次数: 0
Assessing Medication Adherence at a Student-Run Free Clinic in the Midwest 在中西部一家学生开办的免费诊所评估药物依从性
Pub Date : 2023-06-11 DOI: 10.59586/jsrc.v9i1.271
Jess Grimmond, Alex Maben, Kalika Mahato, J. Geske, M. Menning
Background: One of the primary barriers to medication adherence is traversing a physical distance to a pharmacy to pick-up medications. There are few studies that have examined how socioeconomic factors affect patient medication adherence in the context of student-run free clinics (SRFC).  Low medication adherence leads to poorer patient outcomes, especially in patients with chronic diseases. Methods: This retrospective chart review aims to quantify the rate of medication adherence at this student-run free clinic using prescription pick-up rate and medication possession ratio (MPR). This study involved review of medication documentation in the electronic medical record (EMR) and charge reports of dispensed medications from the clinic’s community partner, OneWorld pharmacy. Prescriptions written for and picked up by Student Health Alliance Reaching Indigent Needy Groups (SHARING) patients between January 1, 2018, and May 31, 2020, were included for analysis. Medication adherence was calculated using MPR. Results: 1,396 prescriptions were written for 37 patients over the study period and 177 prescriptions (12.7%) were dispensed. The MPR for the patient population is 0.1128 (Standard Deviation (SD) = 0.36159). It took patients an average of 29.4 days (SD = 44.3) to pick-up medications after the prescription was sent. Discussion: At an off-campus pharmacy, SRFC patients had a low prescription pick-up rate and low medication adherence, with delayed time to prescription pick-up. Further investigations are needed to identify barriers to prescription adherence and improve adherence rates.
背景:药物依从性的主要障碍之一是穿越物理距离到药房取药。很少有研究在学生开办的免费诊所(SRFC)的背景下考察社会经济因素如何影响患者的药物依从性。药物依从性低会导致患者预后较差,尤其是慢性病患者。方法:这项回顾性图表综述旨在通过处方获取率和药物占有率(MPR)来量化这家学生经营的免费诊所的药物依从率。这项研究涉及对电子病历(EMR)中的药物文档的审查,以及诊所社区合作伙伴OneWorld药房的配药费用报告。纳入了2018年1月1日至2020年5月31日期间为学生健康联盟接触愤怒需求群体(SHARING)患者编写和提取的处方进行分析。使用MPR计算药物依从性。结果:在研究期间,为37名患者开出了1396张处方,开出了177张处方(12.7%)。患者群体的MPR为0.1128(标准差(SD)=0.36159)。患者在开具处方后平均需要29.4天(SD=44.3)才能取药。讨论:在校外药房,SRFC患者的处方取药率低,药物依从性低,取药时间延迟。需要进一步的调查来确定处方依从性的障碍并提高依从率。
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引用次数: 0
Development of a User-Informed Social Resource Guide to Improve Identification and Management of Psychosocial Concerns: A Model for the Free Clinic Setting 开发一个用户知情的社会资源指南,以改进对心理社会问题的识别和管理:一个免费诊所设置的模型
Pub Date : 2023-06-05 DOI: 10.59586/jsrc.v9i1.371
Nicholas Peoples, Mary Fang, P. Kontoyiannis, Colton Andrews, Dana Clark
Background: Resource guides, which consolidate information on community resources, are an important tool for linking vulnerable patients to social and health services. Many existing guides, however, are 1) out-of-date, 2) lack user-friendly design features, and 3) lack instructions for how to access services. We describe an effort to optimize a social resource guide for people experiencing homelessness, where the process may serve as a model for other free clinic settings. Methods: From April 2021 to April 2022, we launched a phased social liaison volunteer program at HOMES Clinic, driving the development of a unique community-informed social resource guide. Specifically, we 1) collected and verified word-of-mouth data from the userbase of various social services (i.e. “street smarts”), and 2) designed a user-friendly interface with easy-to-use deliverables for patients. Results: The HOMES Social Resource Guide facilitates care coordination in both the clinic and street settings. A key design feature is that information for each resource is condensed into a 3.5x2.0” card that fits easily into pockets or wallets. The front contains logistic information (e.g., hours, location, phone) and the back describes how to qualify for and access each service. Cards are organized into a binder and provided to patients by trained volunteers in a need-based manner. Since qualifying for many services is contingent upon first meeting other milestones, the guide includes algorithms to ensure we provide all necessary information to meet any identified need. Information is re-verified/updated every six months. The platform is cost-effective: the raw materials together cost $20. Discussion: While resource guides are not a new invention, we propose that our increased emphasis on simplicity, user-friendliness, community participation, and meeting end-user needs offer clear advantages over other common design paradigms. These principles may be relevant to other free clinics in meeting the diverse needs of underserved populations.
背景:综合社区资源信息的资源指南是将弱势患者与社会和卫生服务联系起来的重要工具。然而,许多现有指南1)已经过时,2)缺乏用户友好的设计功能,3)缺乏如何获得服务的说明。我们描述了一项为无家可归者优化社会资源指南的努力,该过程可以作为其他免费诊所的模式。方法:从2021年4月到2022年4月,我们在HOMES诊所启动了一个分阶段的社会联络志愿者计划,推动开发一个独特的社区知情社会资源指南。具体而言,我们1)从各种社会服务(即“街头智能”)的用户群中收集并验证口碑数据,2)为患者设计了一个用户友好的界面,提供易于使用的交付物。结果:《家庭社会资源指南》促进了诊所和街道环境中的护理协调。一个关键的设计特点是,每个资源的信息都被浓缩成一张3.5x2.0英寸的卡片,可以很容易地放入口袋或钱包。正面包含物流信息(如时间、地点、电话),背面描述如何获得和使用每项服务。卡片被整理成活页夹,由经过培训的志愿者以基于需求的方式提供给患者。由于获得许多服务的资格取决于首次满足其他里程碑,因此该指南包括算法,以确保我们提供所有必要的信息来满足任何确定的需求。信息每六个月重新验证/更新一次。该平台具有成本效益:原材料加在一起的成本为20美元。讨论:虽然资源指南并不是一项新发明,但我们建议,与其他常见的设计范式相比,我们更加强调简单性、用户友好性、社区参与和满足最终用户需求,这提供了明显的优势。这些原则可能与其他免费诊所有关,以满足服务不足人群的各种需求。
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引用次数: 1
Understanding the Primary Care Experience in a Student-Run Free Clinic 了解学生开办的免费诊所的初级保健经验
Pub Date : 2023-06-02 DOI: 10.59586/jsrc.v9i1.297
Salmaan Kamal, April E. Hoge, Aerin Derussy, E. Austin, D. Pollio, A. Montgomery, S. Kertesz
Background: Over 100 student-run free clinics (SRFCs) operate in the United States (US), typically serving uninsured populations. To date, there has been no effort to compare the patient-reported primary care experience in SRFCs to those of mainstream primary care (PC) clinics serving similar populations. In this study, we surveyed patients at Equal Access Birmingham (EAB), an SRFC, and compared our results to those from two PC clinics serving homeless-experienced clientele. Methods: We surveyed 60 EAB patients with the validated “Primary Care Quality-Homeless” survey. It generates an overall score and 4 subscale scores (clinician-patient Relationship, perceived inter-provider Cooperation, Accessibility/Coordination, Homeless-Specific Needs). We compared EAB’s ratings to those published for a Veterans Affairs (VA) mainstream PC (n=150) clinic and a homeless-tailored non-VA Health Care for the Homeless (HCH) program (n=195). Results: EAB’s ratings were similar to those of the mainstream VA clinic (p>0.4). EAB scored lower than the homeless-tailored non-VA HCH program in each subscale, though the difference did not achieve statistical significance. EAB patients most often praised the staff’s interpersonal skills. Items in which >25% of respondents gave a negative rating concerned wait times (29%), coordination of care (65%), and perceptions of provider skill (43%). Conclusions: Despite constrained resources, an SRFC scored comparably to a mainstream VA PC setting. SRFCs will play a continuing role in care of uninsured individuals, and while these data suggest SRFC patient experiences are mostly favorable, additional resources may be required to approximate the care experience achieved in clinics tailored for homeless persons.
背景:美国有100多家学生开办的免费诊所,通常为没有保险的人群提供服务。到目前为止,还没有将患者报告的SRFC初级保健经验与为类似人群服务的主流初级保健诊所的初级保健经验进行比较。在这项研究中,我们调查了伯明翰平等准入中心(EAB)的患者,并将我们的结果与两家为无家可归者提供服务的PC诊所的结果进行了比较。方法:我们采用经验证的“无家可归者初级保健质量”调查对60名EAB患者进行了调查。它生成了一个总分和4个分量表得分(临床医生-患者关系、感知的提供者间合作、可及性/协调、无家可归者的特殊需求)。我们将EAB的评分与退伍军人事务部(VA)主流PC诊所(n=150)和无家可归者定制的非退伍军人事务部无家可归者医疗保健计划(HCH)(n=195)的评分进行了比较。结果:EAB的评分与主流VA诊所的评分相似(p>0.05)。EAB在每个分量表中的得分都低于无家可归者定制的非VA HCH项目,尽管差异没有统计学意义。EAB患者最常称赞工作人员的人际交往能力。超过25%的受访者给出负面评价的项目涉及等待时间(29%)、护理协调(65%)和对提供者技能的看法(43%)。结论:尽管资源有限,SRFC的得分与主流VA PC环境相当。SRFC将在照顾没有保险的个人方面发挥持续的作用,虽然这些数据表明SRFC患者的体验大多是有利的,但可能需要额外的资源来接近为无家可归者量身定制的诊所所获得的护理体验。
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引用次数: 0
Creating a Women’s Health Coalition at a Student Run Free Clinic: A Model for Increasing Access to and Quality of Care 在学生开办的免费诊所中建立妇女健康联盟:提高护理机会和质量的一种模式
Pub Date : 2023-05-14 DOI: 10.59586/jsrc.v9i1.366
Lucy Brown, Annie Gensel, E. Steele, Eric Aksu, Samantha McCarty, Kyle Baugh, Jourdan Owens, McKenzie Barber, Maryann Chimhanda
Introduction: At the beginning of 2021, the Indiana University Student Outreach Clinic (IU SOC) conducted an internal audit of cervical cytology and sexually transmitted infection (STI) screening, which showed low rates of preventive screenings and inconsistent follow-up, thereby demonstrating a need to increase reproductive healthcare access to underserved women in Indianapolis.  Methods: To increase access, multiple teams were created within the Women’s Health Coalition (WHC), ensuring robust education, follow-up, and other necessary coordination for patient care. Additionally, the WHC expanded to host a twice-monthly referral-based women’s health clinic that provided care for patients with various chief concerns and preventive care needs. Protocols for wet-mount microscopy and sexual assault were created based on national guidelines, and annual training were provided to all members of the WHC. Community partnerships were formed to expand resources, including ultrasounds, mammograms, and contraception services. Results: The IU SOC increased the prenatal and gynecological services offered over nine months through this initiative. Notably, a higher number of services were offered to patients who qualified for screenings in 2021 than in the prior four years combined, including cervical cytology (24.1% [Confidence Interval (CI) 18.6%, 29.7% vs. 4.2%] [CI 2.9%, 5.5%]), mammogram referrals (23.1% [CI 15.8%, 30.3%] vs. 2.3% [CI 1.0%, 3.6%]), and STI/human immunodeficiency virus (HIV)/Hepatitis testing (54.6% [CI 50.2%, 59.0%] vs 8.1% [CI 6.8%, 9.3%]). Conclusion: Given the success of the WHC, our approach may serve as a student-run model for other patient populations.
前言:2021年初,印第安纳大学学生外展诊所(IU SOC)对宫颈细胞学和性传播感染(STI)筛查进行了内部审计,结果显示预防性筛查率低,随访不一致,从而表明有必要为印第安纳波利斯服务不足的妇女增加生殖保健服务。方法:为了增加获得机会,在妇女健康联盟(WHC)内建立了多个小组,确保对患者护理进行强有力的教育、随访和其他必要的协调。此外,卫生保健中心扩大到每月举办两次以转诊为基础的妇女保健诊所,为有各种主要问题和预防保健需要的病人提供护理。根据国家指导方针制定了湿法显微镜和性侵犯的规程,并向世界卫生大会的所有成员提供了年度培训。建立了社区伙伴关系,以扩大资源,包括超声波检查、乳房x光检查和避孕服务。结果:通过这一举措,IU SOC增加了9个月以上提供的产前和妇科服务。值得注意的是,2021年为符合筛查条件的患者提供的服务数量高于前四年的总和,包括宫颈细胞学检查(24.1%[置信区间(CI) 18.6%, 29.7%对4.2%][CI 2.9%, 5.5%]),乳房x光检查(23.1% [CI 15.8%, 30.3%]对2.3% [CI 1.0%, 3.6%]),性传播感染/人类免疫缺陷病毒(HIV)/肝炎检测(54.6% [CI 50.2%, 59.0%]对8.1% [CI 6.8%, 9.3%])。结论:鉴于WHC的成功,我们的方法可以作为其他患者群体的学生运行模式。
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引用次数: 0
The Intentional Interprofessional Education Model: A Conceptual Framework to Achieve an Interprofessional, Team-Based Approach in a Student Run Clinic 有意的跨专业教育模式:在学生经营的诊所中实现跨专业、基于团队的方法的概念框架
Pub Date : 2023-04-14 DOI: 10.59586/jsrc.v9i1.350
Jessica Nelson, Emma Hart, Eliana L Otero-Bell, H. Rogers, Lindsay Fox, Anthony Fleg
We introduce the conceptual framework of the Intentional Interprofessional Education (Intentional IPE) Model based on the understanding that it takes mindfulness and intentionality for interprofessional teams to build relationships and work together effectively in a structured manner at a Student-Run Clinic (SRC). This Intentional IPE Model developed organically through experiences and conversations over several years among patients, students, and faculty at a SRC in Albuquerque, New Mexico, serving men experiencing homelessness. Teamwork is at the heart of the Intentional IPE Model, and it is also centered on the following values: curiosity, reflective listening, role exploration, vulnerability, respect, mentorship, and patient partnership. For students and faculty to engage in deep and productive interprofessional learning, professional health philosophies, priorities, and roles must be laid out, and curiosity should be encouraged. Our reflective paper emphasizes the ways the Intentional IPE Model can enhance student-faculty-patient experiences in SRC settings
我们介绍了意向性跨专业教育(意向性IPE)模型的概念框架,基于这样一种理解,即跨专业团队需要正念和意向性来建立关系并在 学生诊所(SRC)的结构化方式。这种意向性IPE模式是通过新墨西哥州阿尔伯克基SRC的患者、学生和教职员工多年来的经历和对话有机发展起来的,该SRC为无家可归的男性服务。团队合作是意向IPE模式的核心,它也以以下价值观为中心:好奇心、反思性倾听、角色探索、脆弱性、尊重、指导和耐心伙伴关系。为了让学生和教职员工参与深入而富有成效的跨专业学习,必须制定职业健康哲学、优先事项和角色,并鼓励好奇心。我们的反思性论文强调了意向性IPE模型如何在SRC环境中增强师生患者体验
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引用次数: 0
Evaluating the Prescribing Patterns of Antihypertensive Medications in a Student-Run Free Clinic 学生自办诊所抗高血压药物处方模式评价
Pub Date : 2023-04-11 DOI: 10.59586/jsrc.v9i1.364
Sandra Cabezas, Kahkashan Grant, J. Clark
Background: Hypertension is one of the most widespread disease states and a high-risk factor for developing other cardiovascular diseases such as stroke and coronary disease. In the uninsured population, uncontrolled blood pressure is primarily due to limited access to healthcare. While there has been a review to assess the quality of hypertension management provided at the Building Relationships and Initiatives Dedicated to Gaining Equality (BRIDGE) Clinic, this study will evaluate the prescribing patterns of antihypertensives at the clinic and assess whether the clinic is adhering to current treatment guidelines. Methods: A retrospective chart review was performed for BRIDGE patients 18 years and older that were diagnosed with hypertension between 2012 and 2021. The drug classes studied included thiazide diuretics, calcium channel blockers (CCBs), angiotensin-converting-enzyme inhibitors (ACEI), and angiotensin receptor blockers (ARBs). The initial and maintenance doses were compared to Food and Drug Administration (FDA)-recommended dosing to determine if the appropriate doses were prescribed. Results: A total of 123 patient charts were reviewed. 54.7% of patients with Stage 1 hypertension were initially started on only one medication. For Stage 1 maintenance, 47.3% of the patients were continued on only one medication. In patients with Stage 2, 45.8 % were initially started on a combination of 2 or more medications. For Stage 2 maintenance, 79.2% of the patients were continued on a combination of 2 or more medications. Patients with Stage 1 had prescribing patterns that did not adhere to guidelines while most Stage 2 patients adhered to guidelines. Conclusions: The results suggest that the BRIDGE Healthcare Clinic may be prescribing antihypertensive medications that do not entirely follow the prescribing patterns recommended by the Joint National Committee (JNC) 8 guidelines, which may impact effective treatment outcomes.
背景:高血压是最常见的疾病之一,也是发展其他心血管疾病(如中风和冠状动脉疾病)的高危因素。在没有保险的人群中,血压失控主要是由于获得医疗保健的机会有限。虽然已经对致力于获得平等的建立关系和倡议诊所(BRIDGE)提供的高血压管理质量进行了评估,但本研究将评估该诊所抗高血压药物的处方模式,并评估该诊所是否遵守当前的治疗指南。方法:对2012年至2021年间诊断为高血压的18岁及以上BRIDGE患者进行回顾性图表审查。研究的药物类别包括噻嗪类利尿剂、钙通道阻滞剂(CCBs)、血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARBs)。将初始剂量和维持剂量与美国食品药品监督管理局(FDA)建议的剂量进行比较,以确定是否开出了合适的剂量。结果:共回顾了123张病历。54.7%的1期高血压患者最初仅开始服用一种药物。对于1期维持,47.3%的患者仅继续服用一种药物。在2期患者中,45.8%的患者最初开始服用两种或两种以上药物的组合。对于2期维持,79.2%的患者继续服用两种或两种以上药物的组合。1期患者的处方模式不符合指南,而大多数2期患者则遵守指南。结论:研究结果表明,BRIDGE医疗保健诊所可能开出的抗高血压药物并不完全遵循联合国家委员会(JNC)8指南建议的处方模式,这可能会影响有效的治疗结果。
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引用次数: 0
Implementation of Training Protocols Addressing Equitable Care in US Student-Run Clinics 美国学生诊所公平护理培训协议的实施
Pub Date : 2023-03-31 DOI: 10.59586/jsrc.v9i1.352
Aashka Shah, Nathan Barger, Jessica Ding, Raissa Li, Kuhan A. Mahendraraj, Shrey Patel, Clinton Pong
Background: Student-run clinics (SRCs) provide free healthcare to surrounding communities—oftentimes underserved communities. In these clinics, medical students see a wide array of patients under the supervision of physicians. SRCs have helped to fill a gap in primary care and provide an opportunity for students to refine their clinical skills. However, no uniform training program exists across all student-run clinics. This study aims to assess and analyze the quality and characterization of these training programs to inform future trainings and ultimately provide more equitable care to the communities being served by SRCs. Methods: A nine-question survey was sent out by email to 96 clinics across the United States. Upon obtaining data, the study team de-identified the results. Two independent raters coded the survey responses using an inductive approach. Themes were derived from responses and summarized into nominal codes. Results: The populations served by the clinics that responded in decreasing order of magnitude were underinsured/uninsured (83%); immigrant/non-English speaking populations (75%); black, indigenous, and people of color (67%); homeless (67%); low-income (67%); sex workers (17%); youth (8%); and injection drug users (8%). Nine (75%) clinics had some form of training for volunteers and 3 (25%) offered no formal trainings. 75% of all clinics surveyed offered both “cultural competency” and “general introduction to systems training.” The majority of clinics partnered with local hospitals/clinics (50%). Other community partners included mental health and homeless agencies, local pharmacies, and schools. Two (17%) of the clinics surveyed did not have any community partners. Conclusion: SRCs offer a unique solution towards bridging the gap in health inequity in America. The study shows possible gaps in training among schools in the US. Although some schools have adopted formal, standardized training programs, many do not encompass instruction on topics including cultural humility, trauma-informed care, de-escalation, and population-specific care.
背景:学生开办的诊所(src)为周围社区提供免费医疗服务,通常是服务不足的社区。在这些诊所里,医学生在医生的指导下要看各种各样的病人。src帮助填补了初级保健的空白,并为学生提供了完善临床技能的机会。然而,没有统一的培训计划存在于所有学生经营的诊所。本研究旨在评估和分析这些培训项目的质量和特点,为未来的培训提供信息,并最终为src服务的社区提供更公平的护理。方法:通过电子邮件向美国96家诊所发送了一份包含9个问题的调查。在获得数据后,研究小组对结果进行了去识别。两名独立的评分员使用归纳方法对调查结果进行编码。主题是从回应中衍生出来的,并归纳为名义代码。结果:受访人群中,参保不足/未参保的占83%;移民/非英语人口(75%);黑人、土著人和有色人种(67%);无家可归的人(67%);低收入(67%);性工作者(17%);青年(8%);注射吸毒者(8%)。9个(75%)诊所对志愿者进行了某种形式的培训,3个(25%)诊所没有提供正式培训。接受调查的所有诊所中,有75%提供“文化能力”和“系统一般介绍培训”。大多数诊所与当地医院/诊所结成伙伴关系(50%)。其他社区合作伙伴包括心理健康和无家可归者机构、当地药店和学校。接受调查的诊所中有两家(17%)没有任何社区合作伙伴。结论:src为弥合美国健康不平等的差距提供了独特的解决方案。这项研究显示了美国学校在培训方面可能存在的差距。尽管一些学校已经采用了正式的、标准化的培训项目,但许多学校并没有包括文化谦逊、创伤知情护理、降级和针对特定人群的护理等主题的指导。
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Journal of student-run clinics
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