Abstract
Objective. The goal of this pilot study was to develop and field-test questions for use as a poverty case-finding tool to assist primary care providers in identifying poverty in clinical practice. Methods. 156 questionnaires were completed by a convenience sample of urban and rural primary care patients presenting to four family practices in British Columbia, Canada. Univariate and multivariate logistic regression analyses compared questionnaire responses with low-income cut-off (LICO) levels calculated for each respondent. Results. 35% of respondents were below the “poverty line” (LICO). The question “Do you (ever) have difficulty making ends meet at the end of the month?” was identified as a good predictor of poverty (sensitivity 98%; specificity 60%; OR 32.3, 95% CI 5.4–191.5). Multivariate analysis identified a 3-item case-finding tool including 2 additional questions about food and housing security (sensitivity 64.3%; specificity 94.4%; OR 30.2, 95% CI 10.3–88.1). 85% of below-LICO respondents felt that poverty screening was important and 67% felt comfortable speaking to their family physician about poverty. Conclusions. Asking patients directly about poverty may help identify patients with increased needs in primary care.
Highlights
Tremendous advances have been made in health care delivery; poverty still has a profound impact upon the health of many patients [1,2,3,4]
A Cohen’s kappa of 0.925 reflects the strong correlation between these two measures of poverty, and the low-income cut-off (LICO) was chosen for the remainder of the analysis
Of particular interest is that 84% of respondents below the LICO were “single” and 45% did not own a telephone
Summary
Tremendous advances have been made in health care delivery; poverty still has a profound impact upon the health of many patients [1,2,3,4]. Many family physicians recognize the ongoing impact of poverty upon their patients’ lives; they often feel ill equipped to address these issues in a systematic way [15]. The first step is to identify those affected by poverty and its associated poor health outcomes. In this context, a clinician might consider “case finding for poverty”, for instance, in new patient visits, periodic health exams, or as they see fit. A clinician might consider “case finding for poverty”, for instance, in new patient visits, periodic health exams, or as they see fit This would introduce this important determinant of health into the clinical encounter and facilitate better patientcentered care for those in need while helping physicians identify disparities within their practice populations
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
