RT Journal Article
SR Electronic
T1 How An Academic Direct Primary Care Clinic Served Patients from Vulnerable Communities
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 455
OP 465
DO 10.3122/jabfm.2023.230346R1
VO 37
IS 3
A1 Liaw, Winston
A1 King, Ben
A1 Olaisen, Henry
A1 Pastoor, Sara
A1 Kiaghadi, Amin
A1 Cloven, Nina
A1 Reed, Brian
A1 Matuk-Villazon, Omar
A1 Waldren, Steven
A1 Spann, Stephen
YR 2024
UL http://www.jabfm.org/content/37/3/455.abstract
AB Purpose: Direct primary care (DPC) critics are concerned that the periodic fee precludes participation from vulnerable populations. The purpose is to describe the demographics and appointments of a, now closed, academic DPC clinic and determine whether there are differences in vulnerability between census tracts with and without any clinic patients.Methods: We linked geocoded data from the DPC’s electronic health record with the social vulnerability index (SVI). To characterize users, we described their age, sex, language, membership, diagnoses, and appointments. Descriptive statistics included frequencies, proportions or medians, and interquartile ranges. To determine differences in SVI, we calculated a localized SVI percentile within Harris County. A t test assuming equal variances and Mann-Whitney U Tests were used to assess differences in SVI and all other census variables, respectively, between those tracts with and without any clinic patients.Results: We included 322 patients and 772 appointments. Patients were seen an average of 2.4 times and were predominantly female (58.4%). More than a third (37.3%) spoke Spanish. There was a mean of 3.68 ICD-10 codes per patient. Census tracts in which DPC patients lived had significantly higher SVI scores (ie, more vulnerable) than tracts where no DPC clinic patients resided (median, 0.60 vs 0.47, p-value < 0.05).Conclusion: This academic DPC clinic cared for individuals living in vulnerable census tracts relative to those tracts without any clinic patients. The clinic, unfortunately, closed due to multiple obstacles. Nevertheless, this finding counters the perception that DPC clinics primarily draw from affluent neighborhoods.