JABFM
HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text Freely available
Right arrow Full Text (PDF) Freely available
Right arrow Rapid Responses: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Rapid Responses are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mauksch, L. B.
Right arrow Articles by Cameron, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mauksch, L. B.
Right arrow Articles by Cameron, J.
The Journal of the American Board of Family Practice 16:278-289 (2003)
© 2003 American Board of Family Practice

The Content of a Low-income, Uninsured Primary Care Population: Including the Patient Agenda

Larry B. Mauksch, MEd, Wayne J. Katon, MD, Joan Russo, PhD, Suzanne M. Tucker, EdD, Edward Walker, MD and Janet Cameron, MSW

From the Department of Family Medicine (LBM, WJK, EW), and the Department of Psychiatry and Behavioral Sciences (WJK, JR, EW), University of Washington School of Medicine, Seattle; and the Marillac Clinic (SMT, JC), Grand Junction, Colorado. Address reprint requests to Larry Mauksch, Family Medicine Residency, Box 354775, 4245 Roosevelt Way NE, Seattle, WA 98105

Background: Poor and uninsured people have increased risk of medical and psychiatric illness, but they might be more reluctant to seek care than those with higher incomes. Little information exists about the biopsychosocial problems and concerns of this population in primary care.

Methods: We surveyed 500 consecutive patients (aged 18 to 64 years) in a primary care clinic serving only uninsured, low-income patients. We used self-report questions about why patients were coming to the clinic, a chronic illness questionnaire, the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, and items from the Childhood Trauma Questionnaire. Providers completed a questionnaire naming problems elicited from patients.

Results: Patients reported their most common chronic medical problems to be headaches, chronic back problems, and arthritis. The most common concerns patients wanted to discuss with providers and that providers elicited from patients were problems with mood. Compared with patients without current major mental illness, patients with a current major mental illness reported significantly (P < .001) more concerns, chronic illnesses, stressors, forms of maltreatment and physical symptoms.

Conclusion: The illness content of this uninsured, low-income population is dominated by emotional distress and physical pain. These needs place a serious burden on providers and can complicate management of chronic medical illnesses. Recommendations for specialized interview training and integrating mental health services are discussed.






HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2003 by the American Board of Family Medicine.