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尤尼莫维尔:一家为得克萨斯州南部里奥格兰德河谷聚居区提供初级医疗服务的移动健康诊所。

UniMóvil: A Mobile Health Clinic Providing Primary Care to the Colonias of the Rio Grande Valley, South Texas.

作者信息

Manusov Eron G, Diego Vincent P, Smith Jacob, Garza Jesús R, Lowdermilk John, Blangero John, Williams-Blangero Sarah, Fernandez Francisco

机构信息

Department of Family and Community Medicine, Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX, United States.

Department of Human Genetics, School of Medicine, South Texas Diabetes and Obesity Institute, The University of Texas Rio Grande Valley, Brownsville, TX, United States.

出版信息

Front Public Health. 2019 Aug 21;7:215. doi: 10.3389/fpubh.2019.00215. eCollection 2019.

Abstract

We describe a mobile unit () designed to improve poor healthcare access delivery to residents in two South Texas underserved Colonias. The interprofessional team measured seven clinical outcomes [obesity, diabetes, hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C) levels, and depression], and using the Duke Health Profile, assessed the health-related quality of life (HrQoL). The investigators used previously reported disease prevalence, an implementation model, and community needs-assessments to design an outreach healthcare delivery model. A retrospective review of the cohort provides data used to determine potential predictors of clinical variables, 11 domains of HrQOL, and inter/intra Colonia differences. The average age of patients was 45 years-old and females represented 67% of the population served. Results include a high prevalence of obesity (55.5%), hypertension (39%), diabetes (32.5%), and depression (19%), gender differences, and inter-Colonia differences. A generalized linear mixed model analysis provided associations between clinical outcomes and predictors (age, sex, BMI, PHQ-9 score, HbA1c, blood pressure, serum cholesterol, low HDL, triglycerides, and HrQOL domains). The HrQol domain of low self-perceived health, relates to obesity, diabetes, low HDL, and depression. Depression predicted all 11 domains of the HrQol. The prevalence of diabetes, hypertension, obesity, and depression remains epidemic. Mobile clinics increase access and address highly prevalent illnesses in the Colonias. The data collected can be used to address chronic disease and quality of life, focus care, and direct research in high-need underserved areas.

摘要

我们描述了一个移动医疗单元(),其旨在改善德克萨斯州南部两个医疗服务匮乏的边境居民点居民难以获得医疗服务的状况。跨专业团队测量了七项临床指标[肥胖、糖尿病、高血压、高甘油三酯血症、低高密度脂蛋白胆固醇(HDL-C)水平和抑郁症],并使用杜克健康状况量表评估了健康相关生活质量(HrQoL)。研究人员利用先前报告的疾病患病率、一种实施模式和社区需求评估来设计一种外展医疗服务模式。对该队列的回顾性分析提供了用于确定临床变量、HrQOL的11个领域以及居民点之间/内部差异的潜在预测因素的数据。患者的平均年龄为45岁,女性占所服务人群的67%。结果包括肥胖(55.5%)、高血压(39%)、糖尿病(32.5%)和抑郁症(19%)的高患病率、性别差异以及居民点之间的差异。广义线性混合模型分析提供了临床结果与预测因素(年龄、性别、BMI、PHQ-9评分、糖化血红蛋白、血压、血清胆固醇、低HDL、甘油三酯和HrQOL领域)之间的关联。自我健康感知较低的HrQol领域与肥胖、糖尿病、低HDL和抑郁症有关。抑郁症预测了HrQol的所有11个领域。糖尿病、高血压、肥胖和抑郁症的患病率仍然很高。移动诊所增加了医疗服务的可及性,并解决了边境居民点中高度流行的疾病。所收集的数据可用于解决慢性病和生活质量问题,并在高需求的医疗服务匮乏地区集中医疗护理和指导研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee5/6712363/be27e77fd5fc/fpubh-07-00215-g0001.jpg

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