Disabled, Poverty, Immigrants, Travel Flashcards
Care considerations for the differently abled
Disability patients have poorer overall health, less access to adequate care, and higher rates of risky health behavior
They need more time in exams, help getting into exam positions, or communicate via caretakers
Often don’t get personalized recommendations for care
Secondary conditions such as pain, fatigue, depression can result from a disability
CDC best practices for differently abled
Give each patient information needed to live a long and healthy life
Listen and respond to patient concerns
communicate clearly and effectively, using other means if needed
Take time needed to meet the patient’s health care needs
Have accessible exam rooms and equipment
How do multi-modal treatments influence the differently abled?
More than one method of treatment that can address secondary problems as well as primary problems
Ways to reduce the cost of prescriptions for patients
Pharmacy discount coupons, online pharmacies, simplest regimen, alternative medications / generics, samples, reduced cost programs, Medicaid
Some public health risk diseases may qualify for free medication from health department
Sometimes paying as cash customer with coupons is cheaper than co-pays
How does poverty / lack of insurance affect the design and management of patient care
Inability to receive preventative care, lack of access to specialists, use the simplest medication regimen, consider cost in prescribing medication. Remember that health care is not a urgent problem for those in poverty and after hours care may be needed as missing work can be very detrimental. Even a small co-pay can be too expensive.
What resources for treatment plans reduce the financial burden?
Medicaid, state assistance, community support groups, reduced medication cost programs, free clinics, after hours clinics to reduce need to miss work
How does language / religion / culture and discrimination affect health care delivery?
May not be eligible to buy insurance, may face discrimination in accessing care, may have communication challenges due to language barriers, may fear information about their status is shared to authorities, may have different risk factors for diseases from their home country, there may be cultural beliefs preventing care access
What are best practices for managing care of undocumented migrants?
Understand SDOH
Navigate and advocate for patients
Connect and use community resources
Practice cultural humility
Collaborate and implement quality improvement projects
Utilize different standards of care if needed
Emergency medical assistance (EMA) waiver
5 months of emergency health insurance for patients with a organ or life threatening disease
What are health care issues unique to migrant workers?
Physically demanding / risky jobs
Cold / heat stress when on the move
Toxic exposures (agricultural exemptions for worker protections increase this risk)
Fear of legal issues when seeking care
Lack of follow up
Poorer housing and sanitation
Greater food insecurity / nutrition
Lack of health / social services
Migrant health issues / disease more common
Behavioral
Cancer
Diabetes
Eye issues
HIV/AIDS
Hepatitis
Immunizations
TB
Oral Health
Women’s Health
Preventative recommendations and concerns for international travel
Receive recommended and required vaccines 4-6 weeks before travel
Receive info on managing traveler’s diarrhea
Obtain medical / evacuation insurance
Know their own health care plan while traveling
Check CDC for recommendations
Where should you check for up to date travel health advisories?
CDC Yellow Book
Travel history importance
Some illnesses can take many days to become symptomatic (or weeks) so travel history is vital
CDC recommendations for the care of the returned traveler
complete travel history including places visited, duration, activities, accommodations, transport, exposures, travel precautions, treatments, and full medical history
systemic febrile, diarrheal, and dermatologic are most common.
Eosinophilia suggests helminth infection
Animal bites / scratches - evaluate for rabies
Consider DVT / PE if prolonged sitting / travel (6+ hours)
Consult with infectious disease specialist
