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联邦合格健康中心的内科住院医师连续性诊所:结构、可行性及早期结果

An Internal Medicine Resident Continuity Clinic at a Federally Qualified Health Center: Structure, Feasibility, and Early Outcomes.

作者信息

Hilgeman Brian, Lyons Amalia, MacKinney Theodore, Wilson Pamela, Melster Taylor, Markson Matthew, Fletcher Kathlyn

机构信息

Medical College of Wisconsin, Milwaukee, WI, USA.

Sixteenth Street Community Health Centers, Milwaukee, WI, USA.

出版信息

J Gen Intern Med. 2025 May;40(6):1437-1440. doi: 10.1007/s11606-025-09435-4. Epub 2025 Feb 21.

Abstract

BACKGROUND

Educational opportunities in federally qualified health centers (FQHCs) are important to develop our physician workforce at FQHCs but are rare in internal medicine (IM) training programs.

AIM

To describe the process, feasibility, and early outcomes of an IM resident continuity clinic at a FQHC.

SETTING AND PARTICIPANTS

The IM residency is a large academic program. The FQHC serves over 40,000 patients per year, of which the vast majority are Hispanic/Latino(a) (88%), speak Spanish (69%), live below 100% of the federal poverty level (80%), and rely on Medicaid (60%) or lack insurance (22%).

PROGRAM DESCRIPTION

The continuity clinic was launched in July 2022 with six residents.

PROGRAM EVALUATION

After 18 months, patient panel grew to 680 patients. Patients are young (age 18-39 = 55%), uninsured (54%), below 100% federal poverty line (82%), and Spanish speaking (84%). Residents' continuity was 53.3% with a no-show and same day cancel rate of 26.6%. Residents saw an average of 15.76 patients per day while the attending's non-resident clinic saw 15.44 per day (P = 0.31). Average resident satisfaction was 96%.

DISCUSSION

A collaborative IM resident continuity clinic at a FQHC is feasible, highly satisfying for residents, and cost-neutral for the FQHC.

摘要

背景

联邦合格健康中心(FQHCs)的教育机会对于培养FQHCs的医师队伍很重要,但在内科(IM)培训项目中却很少见。

目的

描述FQHC中IM住院医师连续性诊所的过程、可行性和早期结果。

地点和参与者

IM住院医师培训项目是一个大型学术项目。该FQHC每年服务超过40000名患者,其中绝大多数是西班牙裔/拉丁裔(88%),说西班牙语(69%),生活在联邦贫困线100%以下(80%),依赖医疗补助(60%)或没有保险(22%)。

项目描述

连续性诊所于2022年7月启动,有6名住院医师参与。

项目评估

18个月后,患者名单增加到680人。患者年轻(18 - 39岁占55%),无保险(54%),低于联邦贫困线100%(82%),说西班牙语(84%)。住院医师的连续性为53.3%,爽约和当日取消预约率为26.6%。住院医师平均每天看15.76名患者,而主治医师的非住院医师诊所平均每天看15.44名患者(P = 0.31)。住院医师平均满意度为96%。

讨论

FQHC中合作开展的IM住院医师连续性诊所是可行的,住院医师满意度很高,且对FQHC而言成本中性。

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