By Aine Cryts
It's more difficult for adult patients who can't afford healthy food, prescription drugs or their utility bills to stay healthy, according to a recent study published in BMJ Quality & Safety. But there are steps physician practices can take to help reduce these barriers.
This study involved 3,000 patients treated at two primary care practices at Boston' Massachusetts General Hospital over a seven-month period. Of that number, 416 reported unmet needs and were assisted by an organization called Health Leads that connects patients with community resources.
Some of the study's key findings:
- There was a clear relationship between food access and diabetes control and between transportation access and clinic appointments; however, the study was unable to prove conclusively that access to the services provided reduced the identified problems.
- Women, members of racial or ethnic minorities and Medicaid recipients were more likely to report lack of access to financial and other resources.
- Difficulty paying for healthcare--including prescription drugs--food and utilities were the most-reported unmet needs.
- Patients with unmet needs were more likely to struggle with depression, diabetes and hypertension; these patients were also more likely to visit the emergency department for their care and to miss scheduled clinic appointments.
At the conclusion of the study, 62 percent of patients' needs were either met or they no longer needed support. Four percent continued to have unmet needs, while 34 percent of patients were lost to follow up.
"One thing we are learning is that unmet needs are so common in the U.S.--one third of American adults with a chronic illness have trouble affording food, medication or both--that issues like this will come up in almost any practice," lead author Seth Berkowitz, M.D, of the MGH Division of General Internal Medicine, said in a study announcement. "If practices are willing, programs designed to link patients to basic resources could be relatively easy to generalize. We also need to further refine our interventions so we can connect patients with programs that more completely meet their needs."
In addition to providing access to resources, improving health outcomes for low-income patients requires coordinated, team-based care, lack of judgment, a contextualized care plan and help for the newly insured, as reported previously in FiercePracticeManagement.