1 College of Population Health, University of New Mexico , Albuquerque, New Mexico.
2 Clinical and Translational Science Center, University of New Mexico , Albuquerque, New Mexico.
Popul Health Manag. 2019 Apr;22(2):113-119. doi: 10.1089/pop.2018.0048. Epub 2018 Jul 3.
Understanding how unmet basic needs impact health care in patients with complex conditions is vital to improve health outcomes and reduce health care costs. The purpose of this observational study was to explore the association between health care and socioeconomic needs and health care utilization and disease management among patients with chronic conditions at an intensive, patient-centered, office-based program. The study used a cross-sectional design and a convenience sampling approach. Data were collected through a patient questionnaire and medical records. Analysis included descriptive and inferential statistics. Data from 48 established patients were analyzed. Financial and lack of transportation were the 2 most frequently reported unmet needs. More than 65% of participants had their chronic condition(s) under control. Sex and ethnicity were the only 2 demographic variables that yielded significant differences (P ≤ 0.01) on visits to the emergency room and having chronic condition(s) under control. Those who reported having unmet transportation needs were more likely to have a condition uncontrolled and to have lost medical appointments compared to those who had this social need met (P ≤ 0.05). Statistically significant differences in terms of missing medical appointments also were found between those whose overall financial and housing needs were unmet and those who had those needs met (P ≤ 0.05). Results indicate that participating patients generally had good control of their conditions. The study adds evidence in support of the call for health care to address patients' socioeconomic needs, and the health care benefits of intensive case management programs. The model may be considered for adoption throughout New Mexico, and nationally.
了解未满足的基本需求如何影响复杂病情患者的医疗保健对于改善健康结果和降低医疗保健成本至关重要。本观察性研究的目的是探讨在以患者为中心的强化门诊基础项目中，慢性病患者的医疗保健和社会经济需求与医疗保健利用和疾病管理之间的关联。该研究采用横断面设计和便利抽样方法。通过患者问卷和病历收集数据。分析包括描述性和推断性统计。对 48 名已确诊患者的数据进行了分析。经济和缺乏交通工具是报告中最常见的未满足需求。超过 65%的参与者控制了他们的慢性疾病。性别和种族是仅有的 2 个在急诊就诊和控制慢性疾病方面产生显著差异的人口统计学变量（P≤0.01）。与那些有交通需求未得到满足的人相比，那些报告有未得到满足的交通需求的人更有可能控制病情不佳，并错过医疗预约（P≤0.05）。在总体经济和住房需求未得到满足的人与那些满足这些需求的人之间，也发现了错过医疗预约方面的统计学显著差异（P≤0.05）。结果表明，参与研究的患者通常能够很好地控制他们的病情。该研究为医疗保健满足患者的社会经济需求以及强化病例管理计划的医疗保健益处提供了证据。该模式可考虑在新墨西哥州乃至全国推广。
