Rust G S, Murray V, Octaviani H, Schmidt E D, Howard J P, Anderson-Grant V, Willard-Jelks K
National Center for Primary Care, Morehouse School of Medicine, Atlanta, GA 30310, USA.
J Natl Med Assoc. 1999 Jul;91(7):398-403.
Federally funded community health centers (CHCs) were surveyed to assess their ability to serve low-income asthma patients in the southeastern United States. Data were collected on CHC clinicians, pharmacy services, and patient characteristics. Twenty-six (74%) of 35 participating CHCs provided data on 83 distinct clinic sites in eight states, representing 898,977 billable patient visits to 318,920 people during the one-year study period. Participating CHCs provided 23% of all CHC patient visits in Region IV in 1995. Sixty-two percent of patients had a family income below poverty level. Almost 75% of the patients were uninsured or receiving Medicaid. Asthma was the diagnosis code for 2.04% of all medical encounters. Twenty-nine percent of sites were unable to provide medications for uninsured asthma patients, while 66% could provide drug samples. Thirty-three percent of CHCs had in-house pharmacies and 33% offered pharmacy vouchers. Eighty-two percent could provide beta-agonist inhalers, 54% could provide steroid inhalers, and 17% could provide peak flow meters. Federally funded CHCs provide care to many asthma patients from the highest risk segments of the population, but often do not have the resources needed to follow current clinical guidelines.
对由联邦政府资助的社区健康中心(CHC)进行了调查,以评估其为美国东南部低收入哮喘患者提供服务的能力。收集了有关CHC临床医生、药房服务和患者特征的数据。在参与调查的35家CHC中,有26家(74%)提供了八个州83个不同诊所地点的数据,这些数据代表了在为期一年的研究期间,318,920人进行的898,977次可计费患者就诊。1995年,参与调查的CHC提供了第四地区所有CHC患者就诊量的23%。62%的患者家庭收入低于贫困线。近75%的患者未参保或接受医疗补助。哮喘是所有医疗就诊诊断代码中的2.04%。29%的诊所无法为未参保的哮喘患者提供药物,而66%的诊所可以提供药品样本。33%的CHC设有内部药房,33%提供药房代金券。82%的诊所可以提供β-激动剂吸入器,54%可以提供类固醇吸入器,17%可以提供峰值流量计。由联邦政府资助的CHC为许多来自高危人群的哮喘患者提供护理,但往往没有遵循当前临床指南所需的资源。