A community-based free nursing clinic's approach to management of health problems for the uninsured: the hepatitis C example.
Poverty, as an outgrowth of lack of opportunity in employment, basic education, affordable housing, and racism, directly affects disparities in health status. Health care providers are challenged to identify and overcome systemic barriers to health services for the poorest patients. This article describes the population of patients and the model of care offered by the Wald Community Nursing Center, a free nurse-managed clinic in Baltimore, Maryland. Hepatitis C infection is used to illustrate the confounding factors of a costly, chronic health problem and the interventions that have been instituted to overcome them.
Van Zandt
Shirley E
SE
Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
D'Lugoff
Marion I
MI
Kelley
Lisa
L
D000328:Adult; D000367:Age Factors; D000368:Aged; D019090:Case Management; D003151:Community Health Centers; D003152:Community Health Nursing; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D017057:Medically Uninsured; D009722:Nurse Practitioners; D009739:Nursing Services; D010353:Patient Education as Topic; D012017:Referral and Consultation; D012959:Socioeconomic Factors; D013997:Time Factors; D014478:Unemployment