Birs Antoinette, Liu Xinwei, Nash Bee, Sullivan Sara, Garris Stephanie, Hardy Marvin, Lee Michael, Simms-Cendan Judith, Pasarica Magdalena
University of Central Florida College of Medicine.
FIRE Module, University of Central Florida College of Medicine.
Cureus. 2016 Feb 19;8(2):e500. doi: 10.7759/cureus.500.
Free and charitable clinics are important contributors to the health of the United States population. Recently, funding for these clinics has been declining, and it is, therefore, useful to identify what qualities patients value the most in clinics in an effort to allocate funding wisely. In order to identify targets and incentives for improvement of patients' health, we performed a comprehensive analysis of patients' experience at a free clinic by analyzing a patient survey (N=94). The survey also assessed patient opinions of a small facility fee, which could be used to offset the decrease in funds. Interestingly, our patients believed it is appropriate to be charged a facility fee (78%) because it increases involvement in their care (r = 0.69, p < 0.001) and self-respect (r = 0.66, p < 0.001). Incentives to medical care include continuity of care, faith-based care, having a patient medical provider partnership, and charging a facility fee. Barriers include affordable housing, transportation, medication, and accessible information. In order to improve medical care in the uninsured population, our study suggested that we need to: 1) offer continuity of medical care; 2) offer affordable preventive health screenings; 3) support affordable transportation, housing, and medications; and 4) consider including a facility fee.
免费诊所和慈善诊所对美国民众的健康起着重要作用。近来，这些诊所的资金一直在减少，因此，为了合理分配资金，明确患者最看重诊所的哪些特质很有必要。为了确定改善患者健康状况的目标和激励措施，我们通过分析一项患者调查（N = 94），对一家免费诊所患者的就医体验进行了全面分析。该调查还评估了患者对一项小额设施费的看法，这笔费用可用于抵消资金减少的影响。有趣的是，我们的患者认为收取设施费是合理的（78%），因为这会增强他们对自身医疗护理的参与度（r = 0.69，p < 0.001）以及自尊感（r = 0.66，p < 0.001）。医疗护理的激励因素包括持续护理、基于信仰的护理、建立医患医疗服务提供者伙伴关系以及收取设施费。障碍因素包括经济适用房、交通、药物以及获取信息的便利性。为了改善未参保人群的医疗护理，我们的研究表明我们需要：1）提供持续的医疗护理；2）提供经济实惠的预防性健康筛查；3）支持经济适用的交通、住房和药物；4）考虑收取设施费。
