Rahman Shams, Mirza Abu-Sayeef, Wathington Deanna, Green Shikerria, Mayers Yeshuwa, Iranmanesh Elhaam, Woodard Laurie
Petrock College of Health Sciences, Bethune-Cookman University, Daytona Beach, FL, USA.
Department of Internal Medicine, University of South Florida, Tampa, FL, USA.
Chronic Illn. 2021 Mar;17(1):53-66. doi: 10.1177/1742395319828430. Epub 2019 Feb 19.
Uninsured patients represent an understudied population. The current study aimed to estimate the burden of 10 common chronic conditions and to investigate the associated factors among patients who use free clinics for their health care needs.
Patient charts from four free clinics were reviewed from January to December of 2015. Proportion of prevalence, adjusted odds ratios (AOR), and 95% confidence intervals (CI) for associations between participant characteristics and chronic conditions are reported.
Prevalence of hypertension and hyperlipidemia significantly differed by clinic, age, gender, race, and marital status. Compared to age 15-44 years, older patients (45-64 years, and ≥65) were 5-10 times more likely to suffer from hypertension. Compared to women, men; compared to White, African-Americans; and compared to single, married patients had higher prevalences of hypertension. Older patients were 5-8 times more likely to suffer from hyperlipidemia. Asians, and married patients were also more likely to experience hyperlipidemia. Prevalence of diabetes, depression and arthritis significantly differed by age and race. Prevalence of coronary artery disease and chronic obstructive pulmonary disease increased 6-13 folds among older patients.
Patients of free clinics suffer from high burden of chronic conditions. Patients who frequent free clinics are primarily older, unemployed, women, minorities, and are of low income.
未参保患者是一个研究不足的人群。本研究旨在评估10种常见慢性病的负担，并调查那些因医疗需求而使用免费诊所的患者的相关因素。
回顾了2015年1月至12月来自四家免费诊所的患者病历。报告了参与者特征与慢性病之间关联的患病率比例、调整后的优势比（AOR）和95%置信区间（CI）。
高血压和高脂血症的患病率在诊所、年龄、性别、种族和婚姻状况方面存在显著差异。与15 - 44岁的患者相比，年龄较大的患者（45 - 64岁及≥65岁）患高血压的可能性高5至10倍。与女性相比，男性；与白人相比，非裔美国人；与单身患者相比，已婚患者患高血压的患病率更高。年龄较大的患者患高脂血症的可能性高5至8倍。亚洲人和已婚患者患高脂血症的可能性也更高。糖尿病、抑郁症和关节炎的患病率在年龄和种族方面存在显著差异。老年患者中冠状动脉疾病和慢性阻塞性肺疾病的患病率增加了6至13倍。
免费诊所的患者患有慢性病的负担很重。经常光顾免费诊所的患者主要是老年人、失业者、女性、少数族裔且收入较低。
