• Winston Liaw, Ben King, Henry Olaisen, Sara Pastoor, Amin Kiaghadi, Nina Cloven, Brian Reed, Omar Matuk-Villazon, Steven Waldren, and Stephen Spann.
• From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX (WL, BK); Agency for Healthcare Research and Quality, Rockville, MD; American Academy of Family Physicians, Washington, DC (HO); Elation Health, San Antonio, TX (SP); Texas Water Development Board (AK); Elation Health, Houston, TX (NC); Department of Clinical Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX (BR); Suvida Healthcare, Houston, TX (OMV); American Academy of Family Physicians, Overland Park, KS (SW); University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX (SS). winstonrliaw@gmail.com).
• J Am Board Fam Med. 2024 May 1; 37 (3): 455465455-465.

PurposeDirect primary care (DPC) critics are concerned that the periodic fee precludes participation from vulnerable populations. The purpose is to describe the demographics and appointments of a, now closed, academic DPC clinic and determine whether there are differences in vulnerability between census tracts with and without any clinic patients.MethodsWe linked geocoded data from the DPC's electronic health record with the social vulnerability index (SVI). To characterize users, we described their age, sex, language, membership, diagnoses, and appointments. Descriptive statistics included frequencies, proportions or medians, and interquartile ranges. To determine differences in SVI, we calculated a localized SVI percentile within Harris County. A t test assuming equal variances and Mann-Whitney U Tests were used to assess differences in SVI and all other census variables, respectively, between those tracts with and without any clinic patients.ResultsWe included 322 patients and 772 appointments. Patients were seen an average of 2.4 times and were predominantly female (58.4%). More than a third (37.3%) spoke Spanish. There was a mean of 3.68 ICD-10 codes per patient. Census tracts in which DPC patients lived had significantly higher SVI scores (ie, more vulnerable) than tracts where no DPC clinic patients resided (median, 0.60 vs 0.47, p-value < 0.05).ConclusionThis academic DPC clinic cared for individuals living in vulnerable census tracts relative to those tracts without any clinic patients. The clinic, unfortunately, closed due to multiple obstacles. Nevertheless, this finding counters the perception that DPC clinics primarily draw from affluent neighborhoods.© Copyright 2024 by the American Board of Family Medicine.

26 keywords...

hide…