No. 2, April 2004
SPECIAL TOPICS IN PUBLIC HEALTH
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 18TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Improving Care for the
Homeless Population Using the Chronic Care Model
B Choucair, T Palmer
Suggested citation for this article: Choucair B,
Palmer T. Improving care for the homeless population using the chronic care
model [abstract]. Prev Chronic Dis [serial online] 2004 Apr [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2004/
The objective of this study was to adapt the chronic care model to
improve outcomes among the homeless population in the Health Care for the
Homeless Program at Crusader Clinic in Rockford, Ill.
A major goal of Healthy People 2010 is to eliminate health
disparities. Obtaining baseline data to assess clinical quality is a
necessary step toward identifying areas for eliminating health
disparities between the homeless population and the general population.
Diabetes, hypertension, and asthma were the chronic conditions chosen for
study because of their prevalence among the Rockford, Ill, homeless
population. Staff members were divided into 3 teams, each addressing one of
the chronic conditions. A registry was established to track the outcome of
each condition. The Patient Electronic Care System (PECS), provided by the
Health Disparities Collaborative, was used to track outcomes.
The number of hypertension patients with a blood pressure of less than 140/90
mm Hg increased from a baseline of 31% to 48%, despite the addition of newly
diagnosed patients. Homeless clients with diabetes had an average HbA1c of
7.9%. Among asthma patients, 25% had a severity assessment documented, and
50% had received an influenza vaccine.
Using the chronic care model and intensive follow-up, improvements in
outcomes can be significant, despite many barriers to optimal care among the
Corresponding Author: Bechara Choucair, MD, Health Care for the
Homeless, Medical Director, Crusader Central Clinic Association, 1200 W State
St, Rockford, IL 61102. Telephone: 815-490-1729. E-mail: firstname.lastname@example.org.
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