Hindocha Pooja, Nair Nisha Janardhanan, Pigoga Jennifer L, Barry Katherine, McCarthy Meghan, Almeida-Monroe Valerie, De Groot Anne S
Clínica Esperanza/Hope Clinic, Providence RI; EpiVax, Inc., Providence, RI.
Clínica Esperanza/Hope Clinic, Providence, RI.
R I Med J (2013). 2018 Nov 1;101(9):27-31.
Poor management of chronic diseases, such as hypertension and diabetes, particularly among the uninsured, places medical and financial burdens on the healthcare system. Clínica Esperanza/Hope Clinic initiated a chronic disease management program for uninsured residents of Rhode Island (RI) called Bridging the [Health Equity] Gap (BTG), which offers continuity of care, quarterly goal-setting appointments, and healthy lifestyle interventions. Outcomes for 549 participants from the initial evaluation period are presented here. Over the first 12 months of enrollment, mean hemoglobin A1c decreased from 10.2% to 8.3% (p<0.001), and mean blood glucose of individuals with diabetes decreased by 51 mg/dL (p<0.01). BTG participants used the local emergency department (ED) 60% less than Medicaid-insured RI residents and had 61% fewer "potentially preventable" ED visits. The positive impact of BTG on chronic disease outcomes and ED usage by uninsured patients suggests that programs like BTG may reduce overall healthcare costs in the state.
对慢性病（如高血压和糖尿病）管理不善，尤其是在未参保人群中，给医疗保健系统带来了医疗和经济负担。埃斯佩兰萨诊所/希望诊所为罗德岛州（RI）未参保居民启动了一项名为“弥合[健康公平]差距”（BTG）的慢性病管理项目，该项目提供持续护理、每季度的目标设定预约以及健康生活方式干预。本文展示了初始评估期549名参与者的结果。在入组的前12个月，平均糖化血红蛋白从10.2%降至8.3%（p<0.001），糖尿病患者的平均血糖下降了51mg/dL（p<0.01）。BTG参与者前往当地急诊科（ED）的次数比罗德岛州参保医疗补助的居民少60%，“潜在可预防”的急诊就诊次数少61%。BTG对未参保患者慢性病结果和急诊使用的积极影响表明，像BTG这样的项目可能会降低该州的总体医疗保健成本。
