MacDonald Madeline R, Zarriello Sydney, Swanson Justin, Ayoubi Noura, Mhaskar Rahul, Mirza Abu-Sayeef
Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
College of Public Health, University of South Florida, Tampa, FL, USA.
SAGE Open Med. 2020 Oct 10;8:2050312120965325. doi: 10.1177/2050312120965325. eCollection 2020.
Free clinics manage a diversity of diseases among the uninsured. We sought to assess the medical management of stroke in a population of uninsured patients.
A retrospective chart review was conducted to collect chronic disease statistics from 6558 electronic medical records and paper charts at nine free clinics in Tampa, Florida, from January 2016 to December 2017. Demographics and risk factors were compared between stroke patients and non-stroke patients. Medication rates for several comorbidities were also assessed.
Two percent (107) of patients had been diagnosed with a stroke. Stroke patients were older (mean (M) = 56.0, standard deviation (SD) = 11.2) than the rest of the sample (M = 43.3, SD = 15.4), p < 0.001 and a majority were men (n = 62, 58%). Of the stroke patients with hypertension (n = 79), 81% (n = 64) were receiving anti-hypertensive medications. Of the stroke patients with diabetes (n = 43), 72% (n = 31) were receiving diabetes medications. Among all stroke patients, 44% were receiving aspirin therapy (n = 47). Similarly, 39% of all stroke patients (n = 42) were taking statins.
Uninsured patients with a history of stroke may not be receiving adequate secondary prevention highlighting the risk and vulnerability of uninsured patients. This finding identifies an area for improvement in secondary stroke prevention in free clinics.
免费诊所负责诊治未参保人群中的多种疾病。我们试图评估未参保患者群体中中风的医疗管理情况。
进行了一项回顾性病历审查，以收集2016年1月至2017年12月期间佛罗里达州坦帕市九家免费诊所6558份电子病历和纸质病历中的慢性病统计数据。比较了中风患者和非中风患者的人口统计学特征和风险因素。还评估了几种合并症的用药率。
2%（107名）患者被诊断为中风。中风患者比其余样本年龄更大（平均年龄（M）=56.0，标准差（SD）=11.2），其余样本平均年龄为（M）=43.3，标准差（SD）=15.4，p<0.001，且大多数为男性（n=62，58%）。在患有高血压的中风患者中（n=79），81%（n=64）正在接受抗高血压药物治疗。在患有糖尿病的中风患者中（n=43），72%（n=31）正在接受糖尿病药物治疗。在所有中风患者中，44%正在接受阿司匹林治疗（n=47）。同样，所有中风患者中有39%（n=42）正在服用他汀类药物。
有中风病史的未参保患者可能未得到充分的二级预防，这凸显了未参保患者的风险和脆弱性。这一发现确定了免费诊所二级中风预防方面有待改进的领域。
