The Impact of a Clinic Move on Vulnerable Patients with Chronic Disease: A Geographic Information Systems (GIS) Analysis

The Journal of the American Board of Family Medicine

Andrew Bazemore³  Philip Diller¹  Mark Carrozza² 

[1] Department of Family Medicine, University of Cincinnati (PD), Ohio;Health Foundation of Greater Cincinnati (MC), Ohio;Robert Graham Center, Washington, DC (AB)

关键词: Arthritis;    Case Reports;    Immunizations;    Immunology;    Shoulder;    SIRVA;    Sports Medicine;    Vaccination;   

DOI  :  10.3122/jabfm.2010.01.090103

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Background: Changing locations disrupts the populations served by primary health care clinics, and such changes may differentially affect access to care for vulnerable populations.

Methods: Online geographic information systems mapping tools were used to define how the relocation of a family medicine center impacted access to care for black and Hispanic patients with chronic disease.

Results: Maps created from practice management data revealed a distinct shift in black and Hispanic patients with chronic disease being served in the new location.

Conclusions: Geographic information systems tools are valuable aids in defining changing service areas of primary health care clinics.

Primary health care clinics are bound to the patients they serve by geography, an essential lesson rarely emphasized in preparing resident trainees for community practice.¹ Policy makers promote access to a personal physician for all their constituents, and it is essential that providers understand their service areas and the impact of geography on those they serve. Residency clinics are the training ground for these skills but have traditionally lacked the tools necessary to demonstrate and contextualize caring for patients within the broader community.²

In 2003, hospital finances and politics forced the University of Cincinnati Family Medicine Residency Program (UCFP) to move its outpatient clinic (clinic A) to a new location 6.4 miles to the northeast (clinic B). Being one of the few primary care offices for vulnerable populations living near clinic A, faculty physicians were uncertain if the move would disrupt access to care and continuity for the black and Hispanic patients with the targeted chronic diseases, including diabetes, hypertension, and hyperlipidemia. UCFP physicians hoped to assess the spatial distribution of these vulnerable groups before and after the move but lacked the technical capacity, the knowledge of geographic information systems (GIS), and the funds to conduct spatial analyses. Working with the Robert Graham Center for Policy Studies, UCFP physicians tested whether a new online application intended to simplify the application of GIS for understanding privately held health data—HealthLandscape³—could document how disruptive the move was to the targeted subgroups served by the new office. HealthLandscape is an interactive web atlas that allows health professionals, policy makers, academic researchers and planners to combine, analyze and display information in ways that promote understanding and improvement of health and health care.

【 授权许可】

Unknown   

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