Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Medicine, New York Presbyterian - Columbia University Irving Medical Center, New York, New York, USA.
Teach Learn Med. 2024 Oct-Dec;36(5):624-636. doi: 10.1080/10401334.2023.2245805. Epub 2023 Aug 12.
: Student-run free clinics (SRFCs) serve an integral role in most United States (US) medical schools and contribute substantially to literature on the quality of care to uninsured persons. There has been substantial growth over the past decade of scholarly work produced by SRFCs as they have increased in size and number. Research on patient care outcomes informs better care structures for patients, however there is no current synthesis of patient care outcomes research among SRFCs. This article provides an overview of SRFC research on patient outcomes to understand current research domains and to identify gaps in the literature. : We completed a scoping review by searching Scopus, PubMed, and Journal of Student Run Clinics in June 2021. All peer-reviewed, English-language articles focused on patient-centered outcomes at SRFCs in the US were included. Two independent reviewers performed title, abstract, and full-text screening of relevant works, and eight reviewers conducted data extraction. Descriptive data analysis was performed along with relevant content analysis of patient-centered outcomes. : The search strategy identified 784 studies, of which 87 met inclusion criteria. Most studies were published within the last six years (81.6%), located in California, New York, or Florida (43.7%), and intervention based (33.3%). Many studies (46.0%) had a specific disease of focus of which diabetes was the most researched(19.5%). Patient-centered studies were the leading focus of the study aims (40.2%), where key findings demonstrated primarily improved outcomes in clinic metrics post-intervention (36.8%) or equivalent/better clinical performance than national metrics (20.7%). : This review brings to light gaps in the literature reporting research in SRFCs and can be applied to other low-resource settings. Future efforts to expand SRFC outcomes research should focus on community relationship building, understanding institutional support, and ensuring education on best practices for research within SRFCs. Doing so informs patient care improvement as SRFCs continue to operate as safety net clinics for marginalized populations.
: 学生经营的免费诊所(SRFC)在美国(US)大多数医学院中发挥着不可或缺的作用,并为有关为无保险人员提供护理质量的文献做出了重要贡献。在过去十年中,随着 SRFC 的规模和数量的增加,由其产生的学术研究工作也大量增加。关于患者护理结果的研究为患者提供了更好的护理结构,但目前尚无关于 SRFC 患者护理结果研究的综合分析。本文概述了 SRFC 关于患者结果的研究,以了解当前的研究领域,并确定文献中的空白。 : 我们于 2021 年 6 月在 Scopus、PubMed 和 Journal of Student Run Clinics 上进行了范围界定审查。所有包含在美国的 SRFC 以患者为中心的结果的同行评审的英文文章均包括在内。两名独立的审查员对相关作品进行了标题、摘要和全文筛选,八名审查员进行了数据提取。进行了描述性数据分析,并对以患者为中心的结果进行了相关的内容分析。 : 搜索策略确定了 784 项研究,其中 87 项符合纳入标准。大多数研究在过去六年内发表(81.6%),位于加利福尼亚州、纽约州或佛罗里达州(43.7%),并基于干预(33.3%)。许多研究(46.0%)有一个特定的重点疾病,其中糖尿病是研究最多的(19.5%)。以患者为中心的研究是研究目的的主要重点(40.2%),主要发现是干预后诊所指标的结果得到了改善(36.8%),或者临床表现与国家指标相当/更好(20.7%)。 : 本综述揭示了 SRFC 文献中报告研究的空白,并可应用于其他资源匮乏的环境。未来扩大 SRFC 结果研究的努力应侧重于社区关系建设、了解机构支持,并确保 SRFC 内部的最佳研究实践教育。这样做可以提高患者护理水平,因为 SRFC 继续作为弱势群体的安全网诊所运作。