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- All Subjects: healthcare
- Creators: Gaughan, Monica
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.
Alcohol use disorder is a major problem worldwide and can result in a number of significant physical, social and economic consequences. Specifically when comparing the prevalence of alcohol use disorders in the United States and Spain, it is much higher in the United States, at 13.9% compared with 1.5% in Spain. While there are a number of factors that contribute to a person’s risk, this thesis focuses on possible cultural explanations for these differences. After analyzing current literature surrounding alcohol trends and differing cultures in the US and Spain, the differences could be attributable to the dry drinking culture in the US, and the culture surrounding university - living and college towns in the US. The findings of this study suggest that culture, norms and attitudes surrounding drinking have a large impact on alcohol use disorder, and the US could benefit from implementing strategies to change these norms and attitudes surrounding alcohol, as well as train healthcare providers to have effective, brief counseling conversations.