| Description |
Despite extravagant health care spending in the United States today, a real and significant disparity still exists: The large homeless population is underrepresented in receiving good health care. Research shows the United States (U.S.) is missing its target of providing quality health care to all its citizens, especially within the poor and homeless populations. The U.S. spends more on health care than any other nation in the world, while health outcomes such as Infant Mortality Rates (IMR) in the U.S. are higher than in any other developed country (Davis, Stremikis, Squires, & Schoen, 2014). One of the greatest failings of U.S. healthcare systems is the lack of access to care for low-income and uninsured Americans, missing the target to deliver effective multidimensional health care to all patients (2013 National Healthcare Quality Report, 2014). One of the main reasons homeless populations face barriers in accessing health care services is due to inequitable resources. Without a home or often a car, patients struggle with making appointment times. Research has shown that this affects not only patients, but also providers. Missed appointments cost the U.S. health care system more than $150 billion per year (Zimmer, 2015). In order to try and remedy this issue on a local level, a team of multidisciplinary students and professionals in the Wasatch Valley was formed in 2014 to address the issue of high no show rates in free outpatient clinics in Salt Lake City. I was a founding member of the team, and as my thesis suggests, have had an important role in the design, research, and execution of our study and its proposed solution. The research conducted by our team demonstrated an overwhelming need to reduce the number of missed appointments amongst homeless populations. The solution my research team created was a wearable reminder system tailored to the needs of a homeless person. This research was rooted in community-engagement designed to assist homeless people at a local healthcare clinic. Missed appointments have significant impacts on individuals' health, especially in the homeless population. My research team initially identified the significant problem of missed appointments at the Fourth Street Clinic in Salt Lake City, Utah, a free health care clinic that primarily services the downtown Salt Lake City homeless population. Through a nationwide survey sent to hundreds of homeless health care providers, we found that this problem exists across the entire country (see proof of concept). No-show appointments at outpatient clinics result in decreased efficiency, loss of revenue, and prolonged medical care associated problems (McLean, et al., 2016). Although efforts to reduce missed appointments are being made through the use of email and text message, the nature of homeless life does not align with these reminder modes. Disadvantaged people have been found to be 3 times more likely to miss appointments (Vincent, 2015). Through thorough and diligent research, our team created a durable yet inexpensive device that reminds patients at the following intervals before an appointment: 24 hours before, the morning of, and 1 hour before. This research also utilized feedback from homeless patients. Surveys asking about an ideal device and potential concerns with wearing the device were given to patients at the Fourth Street Clinic. Testing of these devices took place at Mountainlands East Bay Clinic in Provo, |
