RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Preventative Health and Health Maintenance Information for Patients in Monmouth, Oregon: Helping the Patient Help Him(Her)self Project Date: 9/8/2008 Total Health Community Clinic (THCC) primarily serves low income, uninsured or underinsured, individuals. They tend to lack continuity of care and comprehensive care, and often have office visits solely to address acute health issues. Consequently, it is difficult for the health care providers to effectively educate patients on preventative health and health maintenance topics and perform health screening. To facilitate patient knowledge, increase compliance with recommended health screening, and expedite office visits; I created age specific information sheets for patients that outline recommended ways to stay healthy and when specific health screening tests should be performed. Ideally, these will empower the patient to take a more active role in assuring that all of their health care needs are met. Most Wanted: Clandestine Patients Project Date: 6/30/2008 There reside a substantial number of illegal immigrants in Milton-Freewater who are part of the larger Hispanic field worker community. The Hispanics in this rural area are not receiving access to medical care, and the barriers between the physician and this immigrant population in this community are complex, involving economical, social, political and legal factors. Low utilization of primary care services impedes in the prevention and early detection of disease; this negativity impacts the immigrant population as well as the community at large by potentially increasing the incidence of communicable diseases and by driving up healthcare costs due to an increased usage of emergency facilities. In order to investigate the extent to which these healthcare limitations are real and affecting the immigrant population, interviews were conducted and barriers to accessing medical care were discussed. A free blood pressure screening clinic was held three Wednesdays in the evenings at the only clinic in the town. The small turnout at these screenings despite aggressive local promotional efforts proved that the obstacles between provider and the immigrants are even greater than implicated. Traveling to the labor camp in person generated more interest in my project and greater numbers of volunteers were willing to participate in my interview and procedures. The main barriers to healthcare in this population were lack of insurance, fear of deportation, lack of time during the harvesting season, lack of transportation to the low-income clinic in Walla Walla, communication barriers, insufficient education regarding preventive medicine, and a feeling that any treatment will be unaffordable. Increasing awareness was accomplished by having a story printed in the newspaper highlighting that an entire community of field workers receive no primary care. This project has sparked new interest in starting a community-mobile outreach program targeted toward Mexican immigrants in rural areas. Community-based health insurance: an innovative solution for John Day’s un- and under- insured. Project Date: 3/19/2007 The community of John Day, Oregon has a number of un- and under-insured citizens who pay large amounts out-of-pocket on healthcare. Many wait to see an MD until they are sick and do not seek preventive care. They represent the fastest-growing group of uninsured in America: the uninsured who are employed and do not qualify for categorical eligibility for public programs (Medicare, OHP). Patients of the Strawberry Wilderness Community Clinic were surveyed regarding their demographics, insurance status, and opinions on a potential new healthcare plan. This plan, known as community-based health insurance (CHI) is used in developing countries and involves patients contributing a small amount of money per month ($10) to a risk-pool which can then defray healthcare costs among the community. There are certain limitations, and for John Day, the initial plan would only cover the cost of a clinic visit (no meds/labs). Nearly all un- and under-insured surveyed would be interested in this plan and willing to pay the proposed fee. Their concerns were about overuse of the system by a few. Physicians surveyed were all interested in the program, but had serious concerns about cost and too few patients for it to be economically feasible. Momentum for the plan would a barrier to implantation, as healthcare in the US seems to be “stuck” with a lack of innovation for new ways to ensure access. CHI would be one such way. Hepatitis C prevalence rates in West Salem Clinic Homeless versus low-income non-homeless Project Date: 10/18/2004 The hepatitis C virus is a major public health problem and a leading cause of chronic liver disease. In the US, the CDC estimates that there are more than 2.7 million people with ongoing HCV infection. HCV is the leading cause of death from liver disease in the US. Homelessness is an important risk factor for HCV because of the environments ad behaviors associated with homeless communities such as poor hygiene, poor nutrition and high levels of IDU. The goals of the study were to determine the prevalence rates for HCV in the West Salem Clinic populations and to determine how the rates differed between the homeless and the low-income non-homeless. The study also aimed to look at a few of the associated risk factors for HCV such as drug use, alcoholism and STDs. The study showed that the rates of HCV are indeed higher in the homeless than in the low-income non-homeless, as recent literature has indicated. Further research is required to understand the specific associations between various risk factors and the rates of HCV at the West Salem Clinic. The preliminary data indicates a need for further patient education and intervention regarding HCV transmission, especially among the homeless. The Role of a Free Clinic in a Small, Rural Town: A case study in Lebanon, Oregon Project Date: 10/18/2004 Free clinics are located all over the United States, in urban and rural areas alike. These clinics strive to serve the needs of people without health insurance, without access to care, and often, with significant medical illness. These "band-aid" measures to care for the growing access problem in this country serve a vital role in the current health care picture. Communities struggle with increasing numbers of poor and uninsured people with decreasing funds to serve their communities. In Lebanon, Oregon there is a free clinic funded by a hospital foundation that attempts to serve the needs of those without access to health care in East Linn County. While working at the free clinic I discovered a very important lesson: free care is a symbol greater than that of individual health care, it is one of community health. Lack of Health Care benefits Project Date: 3/29/2004 In the past 6 weeks I have been very fortunate to work with Dr. Lance Loberg, Medical Director for NW Human Services community clinics. Because of the comprehensive care provided through this agency, I had the unique opportunity to see patients at the West Salem Clinic, Total Health in Monmouth and H.O.A.P. Mental Health clinic for the homeless and underserved. The experience of being immersed in the lives of such diverse populations enabled me to learn their different interests and life dreams as well as their common fears and frustrations. In a short time, it became frightingly apparent to me how many members of the Salem communty were living with diabetes and felt like they were fighting against more barriers than they could handle. With the decline in health care benefits and services, most patients had lot their mental health and prescription coverage. This left them using unavailable financial resources to provide for medical care and medications. Combined with the current unemployment rate and the increase in costs of living, many hard working people found it necessary to choose between their health and the basic welfare of their family. Help for the Homeless? An exploration of the Assistance Programs Available to the Homeless Population of Salem, Oregon. Project Date: 5/6/2002 Conducted in the community of Salem, Oregon from May to June of 2002, this project sought to explore the needs of the city's homeless population in order to determine if adequate assistance programs are currently in place. Initial interviews with homeless individuals seeking medical treatment were followed by an attempt at characterizing the demographics of this position. Utilizing this initial data, a survey was prepared, and distributed to homeless individuals, that sought to identify which needs were not being satisfactorily met by Salem-area assistance program currently in place. Each agency was contacted and a description of the provided services was obtained, with emphasis on theconcerns raised by survey responders. It was then possible to compare the perceived needs of the homeless population with the services in place to address them. In general, the homeless of Salem, Oregon are pleased with the assistance they receive, but are not very aware of all the programs and agencies available. Further, there is limited communication between these various agencies, and each assistance program is not fully aware of the others in the community. To address this weakness, a current Salem-area resource guide, detailing the services offered to the homeless, was prepared and distributed to local agecies so that a more coordinated effort can be achieved. Back to subject search page or search by preceptor site