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涉及为服务不足人群提供社区医疗保健的教育与服务综合模式:杜兰大学学生运营的免费诊所。

Integrated models of education and service involving community-based health care for underserved populations: Tulane student-run free clinics.

作者信息

Rebholz Casey M, Macomber Meghan W, Althoff Meghan D, Garstka Meghan, Pogribny Andrej, Rosencrans Amanda, Selzer Sydney, Springgate Benjamin

机构信息

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.

出版信息

South Med J. 2013 Mar;106(3):217-23. doi: 10.1097/SMJ.0b013e318287fe9a.

Abstract

OBJECTIVES

Throughout the United States numerous models of local programs, including student-run clinics, exist to address the issue of access to care. The role of these clinics in serving the local community and contributing to medical education has been documented only in limited detail, however. The purpose of this article is to describe the clinic models, patient demographics, and services provided by four student-run clinics in New Orleans.

METHODS

This is a retrospective, multisite chart review study of adult patients examined at student-run clinics between January 1, 2010 and July 31, 2011.

RESULTS

During a 19-month period, 859 patients collectively were seen at the clinics, for a total of 1455 visits. The most common reasons for seeking care were medication refills (21.6%) and musculoskeletal pain (12.0%). Counseling and health education were provided primarily for smoking cessation (9.0%), diabetes management (7.1%), and hypertension management (5.8%). Nearly one-fifth of patients were given a referral to primary care services. In the 2010-2011 academic year, 87.6% of preclinical medical students volunteered at ≥1 of these clinics and spent 4508 hours during 1478 shifts.

CONCLUSIONS

This article highlights the role of student-run clinics in the community, the safety-net healthcare system, and medical education. Future directions include the establishment of a new clinic, fundraising, and prospective studies to further assess the impact of student-run clinics.

摘要

目的

在美国各地,存在着众多地方项目模式,包括学生运营的诊所,以解决医疗服务可及性问题。然而,这些诊所在服务当地社区及促进医学教育方面所发挥的作用,仅有有限的详细记录。本文旨在描述新奥尔良市四家学生运营诊所的诊所模式、患者人口统计学特征及提供的服务。

方法

这是一项回顾性、多地点图表审查研究,研究对象为2010年1月1日至2011年7月31日期间在学生运营诊所接受检查的成年患者。

结果

在19个月的时间里,这些诊所共接待了859名患者,总计就诊1455人次。就诊的最常见原因是续开药物(21.6%)和肌肉骨骼疼痛(12.0%)。咨询和健康教育主要针对戒烟(9.0%)、糖尿病管理(7.1%)和高血压管理(5.8%)。近五分之一的患者被转诊至初级保健服务机构。在2010 - 2011学年,87.6%的临床前医学生在这些诊所中至少一家做志愿者,在1478个班次中共花费4508小时。

结论

本文强调了学生运营诊所在社区、安全网医疗体系及医学教育中的作用。未来的方向包括开设一家新诊所、筹集资金以及开展前瞻性研究,以进一步评估学生运营诊所的影响。

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