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- All Subjects: healthcare
- Creators: Brian, Jennifer
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
Health service quality is understood to be a crucial determinant in successful patient-physician encounters and patient health. One common feeling that patients have reported experiencing during appointments is shame. We hypothesized that patients who experience appearance-based shame during an appointment are not likely to return to the same physician and that patients who do not experience appearance-based shame are likely to return to the same physician. This was assessed by conducting an anonymous online survey of 13 questions that served to establish a general foundation for understanding the participants' physical characteristics such as race, age, weight, and gender identity as well as their overall patient-physician relationship and experiences of shame, if applicable. 119 participants were recruited from Arizona State University and a case study was performed individually for five participants of interest. The data analyzed from this study suggests that while appearance-based shame does exist in healthcare spaces, it is not a significant determining factor in patients returning to their physicians. In addition, there was no significant evidence to suggest that patients who do not experience appearance-based shame are either likely or more likely to return to their physician. We hypothesize this could be due to confounding variables such as convenience, accessibility, or insurance limitations which patients may prioritize over feeling ashamed during an appointment. However, more research needs to be conducted to confirm these hypotheses.