Community-based free clinics: opportunities for interprofessional collaboration, health promotion, and complex care management

Abstract

Objective: Free or outreach clinics offer students the opportunity to work with diverse patient populations. The objective of this study was to describe the demographics and clinical characteristics of a sample of chiropractic patients at a free community-based clinic to assess clinical and educational opportunities for students to work with diverse populations, collaborate with other professions and practice health promotion through patient education. Methods: This was a prospective, descriptive cross-sectional study conducted over 2 months. Data on demographics, health status, and health risks were collected from patients and their interns. Results: Of the 158 patients, 50.6% were women and 50.6% African-American, while only 20.9% were employed fulltime. Of the 24.7% tobacco users, 48.7% expressed interest in cessation. Of 80.0% overweight or obese patients, 48.8% expressed interest in weight loss. By self-report, 16.5% were diabetic, 10.1% took hypertension medication, 36.7% used prescription pain medication (9.4% opiate use), 33.5% used nonprescription pain medication, and 9.4% were under the care of a mental health professional. Conclusion: This patient population is demographically diverse. A high proportion of patients who used tobacco, or were overweight or obese expressed interest in information on those topics. A substantial proportion reported being under care with a mental health professional. This clinic provides opportunities for students to work with diverse populations, collaborate with other professions, and practice health promotion.

Demographics and Clinical Profiles of Patients Visiting a Free Clinic in Miami, Florida

“…Multiple studies have previously investigated the demographics and clinical characteristics of patients utilizing local free clinics in other metropolitan settings (31–38). Common clinical findings across these studies include a higher prevalence of smoking (35, 36), obesity (31, 35, 36), hypertension, asthma, and diabetes (31) amongst this population compared to county or national estimates. Mental health disorders were also noted at increased rates in several studies (31, 34, 36).…”

“…Common clinical findings across these studies include a higher prevalence of smoking (35, 36), obesity (31, 35, 36), hypertension, asthma, and diabetes (31) amongst this population compared to county or national estimates. Mental health disorders were also noted at increased rates in several studies (31, 34, 36). In our study of patients utilizing free medical services of our clinics in Miami-Dade and the adjacent county of Broward in Florida, we found that male patients had a higher prevalence of depression compared to both female patients and the general population of the surrounding county.…”

Volunteer Experiences at a Free Clinic in the United States: A Qualitative Study

“…Free clinics also provide training opportunities to other students such as nursing students [10] and pharmacy students [11]. In addition, free clinics offer opportunities for students to collaborate with other professions [12].…”

Electronic Health Record Implementation: A Quality Assurance Assessment from a Free Clinic Perspective

“…The clinic sees more than 14,000 patient visits each year, and provides an array of services such physical exams, medications, diagnostic testing, and treatments including orthopedics, osteopathic manipulative treatment (OMT), physical therapy, and health education [9]. Coupled with limited access to health care, Yakima County is 49.5% Hispanic, and reports higher incidences of health risk factors such as food insecurity, high cholesterol, and obesity compared to Washington state [10].…”

“…Additionally, patients at free clinics report having difficulty in finding transportation to and from appointments, or cannot miss time from work to see a provider [7,8]. Moreover, free clinics that promote Interprofessional practice allow patients to benefit by seeing multiple providers in a single visit as well as a place for students to learn multidisciplinary care [9].…”