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Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care)
Purpose: Refugee and immigrant patients face significant barriers to health care and are more likely to have poorly controlled chronic disease than the general U.S. population. I-Care aims to improve health equity for refugees and immigrants who face a disproportionate burden of chronic disease. Met...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mary Ann Liebert, Inc., publishers
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8665810/ https://www.ncbi.nlm.nih.gov/pubmed/34909549 http://dx.doi.org/10.1089/heq.2020.0143 |
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author | Sous, Waseem Lupone, Christina D. Harris, Megan A Mohamed, Ayan Mohamed, Liban Lakomski, Mary Jo Seward, Simone Shaw, Andrea V. |
author_facet | Sous, Waseem Lupone, Christina D. Harris, Megan A Mohamed, Ayan Mohamed, Liban Lakomski, Mary Jo Seward, Simone Shaw, Andrea V. |
author_sort | Sous, Waseem |
collection | PubMed |
description | Purpose: Refugee and immigrant patients face significant barriers to health care and are more likely to have poorly controlled chronic disease than the general U.S. population. I-Care aims to improve health equity for refugees and immigrants who face a disproportionate burden of chronic disease. Methods: Refugees and immigrants with uncontrolled diabetes and associated cardiovascular risk factors were enrolled in a care management program within an academic adult medicine clinic. The program utilized a care manager to coordinate care and services between designated primary care providers, affiliated clinical teams, and community partners. Health literacy, chronic disease parameters, and care utilization were assessed at enrollment and 8–12 months later. Results: A total of 50 refugees and immigrants were followed for 8 to 12 months. Clinical parameters found a reduced mean HbA1c from 9.32 to 8.60 (p=0.05) and reduced low-density lipoprotein mean from 96.22 to 86.60 (p=0.01). The frequency of normal blood pressures was 9 (18%) at enrollment and 16 (32%) at 1 year. The cumulative frequency of emergency room visits decreased from 66% to 36% and hospitalizations from 22% to 8%. Rates of comprehensive care monitoring, including monofilament testing and one-time ophthalmology visits, increased from 60% to 82% and from 32% to 42%, respectively. Cumulative frequency of interdisciplinary support engagement with pharmacy and nutrition visits increased from 58% to 78% and from 26% to 38%, respectively. Conclusion: This program highlights the importance of a multidisciplinary community-engaged care model that has demonstrated improvement in quality metrics and health care costs for refugees and immigrants. |
format | Online Article Text |
id | pubmed-8665810 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Mary Ann Liebert, Inc., publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-86658102021-12-13 Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care) Sous, Waseem Lupone, Christina D. Harris, Megan A Mohamed, Ayan Mohamed, Liban Lakomski, Mary Jo Seward, Simone Shaw, Andrea V. Health Equity Original Research Purpose: Refugee and immigrant patients face significant barriers to health care and are more likely to have poorly controlled chronic disease than the general U.S. population. I-Care aims to improve health equity for refugees and immigrants who face a disproportionate burden of chronic disease. Methods: Refugees and immigrants with uncontrolled diabetes and associated cardiovascular risk factors were enrolled in a care management program within an academic adult medicine clinic. The program utilized a care manager to coordinate care and services between designated primary care providers, affiliated clinical teams, and community partners. Health literacy, chronic disease parameters, and care utilization were assessed at enrollment and 8–12 months later. Results: A total of 50 refugees and immigrants were followed for 8 to 12 months. Clinical parameters found a reduced mean HbA1c from 9.32 to 8.60 (p=0.05) and reduced low-density lipoprotein mean from 96.22 to 86.60 (p=0.01). The frequency of normal blood pressures was 9 (18%) at enrollment and 16 (32%) at 1 year. The cumulative frequency of emergency room visits decreased from 66% to 36% and hospitalizations from 22% to 8%. Rates of comprehensive care monitoring, including monofilament testing and one-time ophthalmology visits, increased from 60% to 82% and from 32% to 42%, respectively. Cumulative frequency of interdisciplinary support engagement with pharmacy and nutrition visits increased from 58% to 78% and from 26% to 38%, respectively. Conclusion: This program highlights the importance of a multidisciplinary community-engaged care model that has demonstrated improvement in quality metrics and health care costs for refugees and immigrants. Mary Ann Liebert, Inc., publishers 2021-11-17 /pmc/articles/PMC8665810/ /pubmed/34909549 http://dx.doi.org/10.1089/heq.2020.0143 Text en © Waseem Sous et al., 2021; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by/4.0/This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Sous, Waseem Lupone, Christina D. Harris, Megan A Mohamed, Ayan Mohamed, Liban Lakomski, Mary Jo Seward, Simone Shaw, Andrea V. Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care) |
title | Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care) |
title_full | Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care) |
title_fullStr | Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care) |
title_full_unstemmed | Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care) |
title_short | Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care) |
title_sort | integrated care management to improve diabetes outcomes in refugee and immigrant patients (i-care) |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8665810/ https://www.ncbi.nlm.nih.gov/pubmed/34909549 http://dx.doi.org/10.1089/heq.2020.0143 |
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