Filtering by
- All Subjects: healthcare
- Creators: School of Human Evolution and Social Change
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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.
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For most women, pregnancy is the period in which they will have more interaction with the healthcare field than any other period in their lives. The quality and accessibility of obstetric care varies greatly throughout the United States, and health disparities in this field have the largest impact on African American women. Black mothers in the U.S. are three to four times more likely than white mothers to die as a result of pregnancy related complications. The increased risk of maternal morbidity and mortality seen in the African American population is largely due to preventable causes. This thesis project includes three case studies which analyze the most prevalent and preventable sources of health disparity affecting Black mothers: preeclampsia, hemorrhage, and cesarean section. Possible solutions to each of these disparities are explored on an individual, institutional, and societal scale.