FAMILY MEDICINE AND THE HEALTH CARE SYSTEM
Rebecca T. Putnam, MD; Phillip M. Hughes, MS, PhD; Chelsea C. Atkins, MS, MPH; C. Micha Belden, PhD
Corresponding Author: Rebecca T. Putnam, MD; Department of Family Medicine, Mountain Area Health Education Center
Email: rebecca.putnam@mahec.net
DOI: 10.3122/jabfm.2024.240183R2
Keywords: Access to Care, Autism Spectrum Disorders, Intellectual Disability, Interdisciplinary Health Team, Organizational Innovation, Population Health, Practice-Based Research, Primary Health Care, Referral and Consultation, Retrospective Studies, Spatial Analysis, Quality of Care, Vulnerable Populations
Dates: Submitted: 05-03-2024; Revised: 07-29-2024; 08-19-2024; Accepted: 09-03-2024
FINAL PUBLICATION: |HTML| |PDF|
PURPOSE: To provide an overview of an innovative, consultative care model for patients with Intellectual and Developmental Disabilities (IDD) within a Family Medicine department.
METHODS: We conducted a retrospective chart review of all patients seen in the clinic between 2017-2023 to identify patient demographics (e.g., age), clinical needs (e.g., diagnoses and referral needs), and administrative characteristics (e.g., Medicaid status). We also conducted a spatial analysis to evaluate each patient’s estimated travel distance and time to the clinic.
RESULTS: The number of patients seen in the IDD clinic totaled 184, with 65% male patients (n=120) and a mean age of 31.29 years (SD: 16.27). More than half of patients, 65%, were insured by Medicaid (n=119), and almost half received services paid for by the state Medicaid waiver (43%, n=80). Many patients lived with family (64%, n=117) and reported family guardianship (55%, n=101). The spatial analysis identified that the majority of patients, 86% (n=159) were non-rural residents based on Rural-Urban Continuum Codes. The mean distance traveled was 20.41 (SD: 21.36) miles with a mean travel time of 27.08 minutes (SD: 21.78). Following the consultations, 38% received outgoing referrals. Referral locations included psychiatry (8%), neurology (3%), behavioral health counseling (3%), and other medical services (17%).
CONCLUSION: This study demonstrates the diverse characteristics of patients with IDD receiving care through a consultative-based model of care. This model appeared to provide services for patients from a wide geographic catchment area that may not have otherwise had healthcare access.