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Community Health Centers Primary Care Physicians' Asthma Management Perception of Uninsured Patients
1Mary Bynum, MA, BSN, RN, CCM, DHA, is the Department Chair for Healthcare Programs, Program Chair for the Healthcare Management Program, and Lead Faculty for the Public Administration Program at Franklin University. Dr. Bynum received her doctorate in Health Administration from the University of Phoenix. In addition, she holds a Master of Arts in Public Policy and Management and Bachelor of Science in Nursing from the Ohio State University. Dr. Bynum is a certified case manager and a registered nurse. She has an extensive background in operational excellence, project management, regulatory adherence, and health care policy. She has served more than 22 years in both the public and private sectors. Her research interests include vulnerable populations, health disparities, health policy, and social determinants of health. Dr. Bynum is a national speaker and wellness enthusiast. She is a member of Alpha Kappa Alpha Sorority, Incorporated, Franklin County Children Services Citizens Advisory Committee, Central Ohio Case Management Network, and Fort Hayes Metropolitan Education Center Health Science and Dental Hygiene Advisory Board and is the founder of the Legacy Group of Ohio. She is the recipient of the Stephan Shank award for Teaching Excellence. In addition, she is a marathon runner and fitness guru.
Purpose Of Study:
Explore the perceptions of primary care physicians (PCPs) from community health care centers (CHCs) in Franklin County, Ohio, regarding factors that contribute to their inability to consistently provide sustainable asthma management services to their uninsured patient population.
Primary Practice Setting:
Asthmatic patients are not consistently receiving sustainable asthma management in CHCs in Ohio. Primary care physicians in CHCs play a pivotal role in closing health care gaps for asthmatic patients. To minimize the barriers that impede the efforts of PCPs to control asthma for their uninsured patients, asthma disease management programs that include case management services in CHCs in Franklin County, Ohio, are needed.
Methodology And Sample:
A convenience sample of 4 PCPs from 2 CHCs in Franklin County, Ohio, was interviewed face-to-face. Interviews, direct observation, and previously published research were the sources of data utilized for this study.
Results:
Results indicated that 75% of participants did not use standard guidelines while treating their patients. Physician time constraints and access to affordable medication were identified as some of the barriers to providing sustainable asthma management services.
Implications For Case Management:
Asthma is a complex chronic disease. Disease case managers not only are capable of coordinating health care services for a variety of patient populations but are also effective in managing complex diseases such as asthma for disadvantaged populations. Evidence-based case management models are needed to support PCPs in CHCs. Without the inclusion of asthma-specific case managers as part of the care delivery structure, CHCs may continue to provide subpar disease management services for uninsured asthmatic patients.
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