Rojas Steven M, Smith Sunny D, Rojas Sarah, Vaida Florin
Scripps Mercy Hospital, Chula Vista Family Medicine Residency Program.
Fam Med. 2015 Apr;47(4):309-14.
Student-run free clinics (SRFC) aim to improve health outcomes of vulnerable populations by providing care to those who have difficulty accessing the traditional health care safety net. Reducing low density lipoprotein (LDL) is known to improve health outcomes, yet uninsured patients remain especially susceptible to poor control. This study describes hyperlipidemia control over time among patients who received care at three University of California San Diego Student-Run Free Clinic Project (SRFCP) sites.
The authors performed a retrospective review of clinic visits from August 2006--November 2010 from three sites of the SRFCP. Patients with a new diagnosis of hyperlipidemia, a baseline LDL level, and at least one follow-up LDL drawn between 6 weeks and 18 months were included in this study (n=96). Hyperlipidemia control was analyzed using descriptive statistics, Fisher's exact tests, paired t tests, and binary logistic regression.
At the last visit, 58.3% (56/96) of patients had achieved LDL goal. LDL decreased from a baseline mean of 135.8 mg/dL to 101.3mg/dL among the cohort (P<.001). Statins were used in 86.5% (83/96) of patients. No significant differences were noted when stratified by language, gender, diabetes comorbidity, homelessness, or clinic site. When comparing Hispanics and Caucasians only, Hispanic patients had better LDL control than Caucasians.
This study demonstrates that a SRFC can effectively manage hyperlipidemia over time, and rates of control can exceed national standards.
学生运营的免费诊所(SRFC)旨在通过为那些难以获得传统医疗安全网服务的人群提供医疗服务,改善弱势群体的健康状况。降低低密度脂蛋白(LDL)已知可改善健康状况,但未参保患者仍然特别容易出现控制不佳的情况。本研究描述了在加利福尼亚大学圣地亚哥分校学生运营的免费诊所项目(SRFCP)的三个地点接受治疗的患者随时间推移的高脂血症控制情况。
作者对2006年8月至2010年11月期间SRFCP三个地点的门诊就诊情况进行了回顾性分析。本研究纳入了新诊断为高脂血症、有LDL基线水平且在6周和18个月之间至少进行过一次LDL随访检测的患者(n = 96)。使用描述性统计、Fisher精确检验、配对t检验和二元逻辑回归分析高脂血症控制情况。
在最后一次就诊时,58.3%(56/96)的患者达到了LDL目标。队列中LDL从基线平均水平135.8mg/dL降至101.3mg/dL(P <.001)。86.5%(83/96)的患者使用了他汀类药物。按语言、性别、糖尿病合并症、无家可归状况或诊所地点分层时未发现显著差异。仅比较西班牙裔和白种人时,西班牙裔患者的LDL控制情况优于白种人。
本研究表明,SRFC能够随时间有效地管理高脂血症,且控制率可超过国家标准。