Comparing Patient Care Models at a Local Free Clinic vs an Insurance- Based University Medical Center
Year: 2024
Type: article
Study design: Observational Study
Abstract: More than 30 million Americans lack access to affordable health care, and many seek medical services such as dermatologic care at free clinics.In this study, we analyzed the dermatology patient populations at the Birmingham Free Clinic (BFC) and the University of Pittsburgh Medical Center (UPMC), both in Pittsburgh, Pennsylvania.A retrospective chart review of 76 BFC dermatology patients and a time-matched sample of 322 UPMC dermatology patients was performed for the period from January 2020 to May 2022.Dermatologic care at both clinics can be improved by strengthening communication with patients with limited English proficiency (LEP), providing skin care education, and offering social and scheduling services such as transportation, insurance assistance, and triage.A pproximately 25% of Americans have at least one skin condition, and 20% are estimated to develop skin cancer during their lifetime.1,2 However, 40% of the US population lives in areas underserved by dermatologists.3 The severity and mortality of skin cancers such as melanoma and mycosis fungoides have been positively associated with minoritized race, lack of health insurance, and unstable housing status.[4][5][6] Patients who receive health care at free clinics often are of a racial or ethnic minoritized social group, are uninsured, and/or lack stable housing; this underserved group also includes recent immigrants to the United States who have limited English proficiency (LEP).7 Only 25% of free clinics offer specialty care services such as dermatology.7,8 Of the 42 free clinics and Federally Qualified Health Centers in Pittsburgh, Pennsylvania, the Birmingham Free Clinic (BFC) is one of the few that offers specialty care services including dermatology.9 Founded in 1994, the BFC serves as a safety net for Pittsburgh's medically underserved population, offering primary and acute care, medication access, and social services.From January 2020 to May 2022, the BFC offered 27 dermatology clinics that provided approximately 100 people with comprehensive care including full-body skin examinations, dermatologic diagnoses and treatments, minor procedures, and dermatopathology services.In this study, we compared the BFC dermatology patient care model with that of the dermatology department at the University of Pittsburgh Medical Center (UPMC), an insurance-based tertiary referral health care system in western Pennsylvania.By analyzing the demographics, dermatologic diagnoses, and management strategies of both the BFC and UPMC, we gained an understanding of how these patient care models Comparing Patient Care Models at a Local Free Clinic vs an Insurance-Based
Source: Cutis
DOI: 10.12788/cutis.1138
Author: Alice Lin
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4405369717