Health Outcomes of Kansas City's Vulnerable Patients Following Shutdown: An Assessment of Blood Pressure Among Sojourner Health Clinic Patients.

Abstract

BackgroundIn downtown Kansas City, patients who face homelessness or unstable housing situations may have been negatively affected by the shutdown of Sojourner Health Clinic (SOJO), a free student-run clinic that provides primary care predominantly to these patients. Research shows that blood pressure (BP) increases within weeks or months of interruption of antihypertensive therapy, especially in patients with advanced age and polypharmacy. Therefore, this study will examine how patients’ blood pressure changed after the closure of Sojourner Health Clinic.MethodsThe study population consists of Sojourner Health Clinic patients who were seen both before March 2020 (shutdown) and during/after July 2020 (clinic reopening). Participants are selected at random. No additional data is collected outside of routine treatment for this institutional review board (IRB)-exempt project. A study coordinator reviews charts via Sojourner electronic medical record (EMR) and collects the latest BP available before March 2020 and the first BP available during/after July 2020. No identifying information is collected. The mean systolic pressures, mean diastolic pressures, and mean arterial pressures (MAP) are compared via paired t-test for statistical significance.ResultsThere was a statistically significant decrease in patients’ MAP and diastolic BP after the closure of the clinic. However, there was not a statistically significant change found in patients’ systolic BP. The clinical significance of these results is limited by the minimal magnitude of change.ConclusionsThese findings run counter to our expectations since we believed that the closure of Sojourner Health Clinic would correlate with worsened markers of health, such as blood pressure control. It may be possible that the sampled patients turned to other sources for health maintenance and antihypertensive therapy during clinic closure. Future studies could explore these possibilities.