083 Epidemiology and Economics of a Vulnerable Population

Abstract

Vulnerable populations generally have decreased access to health care, often present with advanced disease processes and experience poorer health outcomes compared to the general population. Here we report on the epidemiology and economics of a vulnerable population with chronic wounds served by an academic medical center that is the tertiary health care provider and referral center for the state of Mississippi. Data are being collected to determine if aggressive management and treatment improves health outcomes. The epidemiology of our population indicates that 48% are over 60 years of age; 45% are between 41–59 years of age; and 7% are under 40 years of age. About 61% are female and almost 39% male. Our vulnerable population is composed of 51.6% African Americans; 6.5% Native Americans; and 3.2% Hispanic Americans; with the remaining population or 38.7% Caucasian. The etiologies of wounds seen are 31% diabetic/neuropathic and 28.5% venous; followed by smaller percentages of surgically treated diabetic and venous wounds. We have found that this population commonly presents with a single wound, but that more than half (>50%) present with two or more wounds. A majority of these individuals (77%) visit the clinic more than two times, with most, or 44% visiting the clinic from two to five times. A smaller percentage, or about 30% visit the clinic six or more times. About 61% are either Medicare or Medicaid, or a combination, while the remainder are covered by private insurance (23%), workman’s compensation (3.2%), or are self-pay (12.9%). Despite this profile, the aggressive integration of a social worker in our clinic results in 35.5% being followed by home health. Thus, we will present data on whether the opening of a specialized treatment center results in better health outcomes in vulnerable populations once individuals receive appropriate referral and treatment.